ICU nurses feel unprepared to care for patients with mental illness : A survey of nurses' attitudes, knowledge, and skills
- Authors: Weare, Reuben , Green, Cameron , Olasoji, Michael , Plummer, Virginia
- Date: 2019
- Type: Text , Journal article
- Relation: Intensive and Critical Care Nursing Vol. 53, no. (2019), p. 37-42
- Full Text: false
- Reviewed:
- Description: Objectives: To examine the knowledge, skills, and attitudes of a cohort of Australian nurses towards caring for patients with mental illness in the intensive care unit. Research design: A questionnaire was developed and distributed via internal email to all nurses working in the study intensive care unit. Responses were anonymous. Setting: A metropolitan intensive care unit located in Melbourne, Australia. Main outcome measures: Intenisve care nurses completed a 76-question self-administered questionnaire. Results: Forty intensive care nurses completed the survey, a response rate of 35.7% (n = 40/112). Respondents were predominantly female (82.5%) and held a post-graduate qualification (62.5%). ICU nurses felt that they needed further training and education to care for patients with mental illness in the intensive care unit. While respondents were empathetic to this patient group, negative stereotypes and stigma were reported by some participants. The pressures of the environment were perceived barriers to delivering optimal person-centred care for patients with mental illness. Conclusion: This sample of nurses felt they require education and support in order to care for patients with mental illness in the intenisve care unit. Further education may also help to reduce negative perceptions of this patient group.
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
- Full Text: false
- Reviewed:
- 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