The therapeutic relationship is the central focus of nursing work in mental health (Peplau, 1992, 1997). However, there is currently little research that has examined influences on the nurses’ capacity to effectively engage in this relationship. This study investigated the impact of nurse, patient and work environment factors on the willingness and ability of nurses to engage in therapeutic relationships. This attribute of the nurse, identified as therapeutic commitment, is essential for an effective therapeutic relationship (Lauder, et al., 2000; Rogers, 1957), which has been identified by users of mental health services as the foundation of their care (Forchuk & Reynolds, 2001). The therapeutic relationship is central to nursing in mental health and has been linked to improved patient outcomes (Horvath, 2005). Environmental factors hypothesised to impact the nurse’s therapeutic commitment included leadership, collegial nurse-doctor relationships, participation in hospital affairs, the foundations of quality nursing, clinical supervision, staffing, skill mix and patient turnover (Aiken, et al., 2008; Duffield, et al., 2009a; Estabrooks, et al., 2002; Kramer & Schmalenberg, 2004; Lake & Friese, 2006; McGillis-Hall & Doran, 2004; Needleman, et al., 2002; Proctor, 1986). These factors, together with measures of the nurse’s qualifications and experience, were assembled into an hypothesised model, based on an earlier framework that included the nurse’s perception of support, adequacy and legitimacy in their role along with their therapeutic commitment (Lauder, et al., 2000; Shaw, et al., 1978). Data were collected from 76 nurses across six mental health wards in general acute hospitals in New South Wales. A nurse survey collected the identified factors using the Practice Environment Scale of the Nursing Work Index (Lake, 2002), the Mental Health Problems Perception Questionnaire (Lauder, et al., 2000), and other questions. A ward profile was used to collect staffing, skill mix and patient movement data. Partial least squares path modelling was applied to the model in order to identify the most influential relationships. The most significant factors in the model were the foundations for quality care, nurse experience, participation in hospital affairs and clinical supervision. Services should enhance the support provided to clinical nurses in mental health through improved access to preceptorship, continued education and clinical supervision. In addition, the therapeutic commitment of nurses in mental health can be increased through improved continuity of care, access to career development opportunities such as the involvement of mental health nurses in the governance of the hospital, and improved responsiveness of administration to the needs of nurses in mental health. Engagement in these supportive activities should be enacted through structured mechanisms that both facilitate involvement and encourage evaluation. This study provides a basis on which to modify the operation of mental health services in general hospitals in order to improve the nursing work environment.

The therapeutic relationship is the central focus of nursing work in mental health (Peplau, 1992, 1997). However, there is currently little research that has examined influences on the nurses’ capacity to effectively engage in this relationship. This study investigated the impact of nurse, patient and work environment factors on the willingness and ability of nurses to engage in therapeutic relationships. This attribute of the nurse, identified as therapeutic commitment, is essential for an effective therapeutic relationship (Lauder, et al., 2000; Rogers, 1957), which has been identified by users of mental health services as the foundation of their care (Forchuk & Reynolds, 2001). The therapeutic relationship is central to nursing in mental health and has been linked to improved patient outcomes (Horvath, 2005). Environmental factors hypothesised to impact the nurse’s therapeutic commitment included leadership, collegial nurse-doctor relationships, participation in hospital affairs, the foundations of quality nursing, clinical supervision, staffing, skill mix and patient turnover (Aiken, et al., 2008; Duffield, et al., 2009a; Estabrooks, et al., 2002; Kramer & Schmalenberg, 2004; Lake & Friese, 2006; McGillis-Hall & Doran, 2004; Needleman, et al., 2002; Proctor, 1986). These factors, together with measures of the nurse’s qualifications and experience, were assembled into an hypothesised model, based on an earlier framework that included the nurse’s perception of support, adequacy and legitimacy in their role along with their therapeutic commitment (Lauder, et al., 2000; Shaw, et al., 1978). Data were collected from 76 nurses across six mental health wards in general acute hospitals in New South Wales. A nurse survey collected the identified factors using the Practice Environment Scale of the Nursing Work Index (Lake, 2002), the Mental Health Problems Perception Questionnaire (Lauder, et al., 2000), and other questions. A ward profile was used to collect staffing, skill mix and patient movement data. Partial least squares path modelling was applied to the model in order to identify the most influential relationships. The most significant factors in the model were the foundations for quality care, nurse experience, participation in hospital affairs and clinical supervision. Services should enhance the support provided to clinical nurses in mental health through improved access to preceptorship, continued education and clinical supervision. In addition, the therapeutic commitment of nurses in mental health can be increased through improved continuity of care, access to career development opportunities such as the involvement of mental health nurses in the governance of the hospital, and improved responsiveness of administration to the needs of nurses in mental health. Engagement in these supportive activities should be enacted through structured mechanisms that both facilitate involvement and encourage evaluation. This study provides a basis on which to modify the operation of mental health services in general hospitals in order to improve the nursing work environment.

No description available.

Ethnic identity, or one's feelings of belongingness and affirmation with one's ethnic group, has been postulated to be related to one's psychological health. Specifically, it is thought that stronger ethnic identity is related to better psychological health. In order to fully investigate this relationship, a meta-analytic review and analysis was conducted utilizing all previous research on the relationship between ethnic identity and psychological health. This study sought to examine this relationship in more detail by dividing psychological health into two areas: 1) psychological functioning, and 2) psychological dysfunction. Both of these categories were examined and analyzed separately utilizing a random effects model. Results indicated a significant relationship between ethnic identity and psychological health. Additionally, ethnic identity was shown to be significantly and inversely related to psychological dysfunction. Several moderators (age, gender, publication status, type of ethnic identity measure, ethnic group membership) were tested for their respective effects on these relationships. For ethnic identity and psychological health, several variables moderated this relationship, including publication status, ethnic identity measure, and ethnic group membership. For ethnic identity and psychological dysfunction, the following variables moderated the relationship: age, gender, ethnic identity measure, and ethnic group membership. Limitations, implications, and future directions are discussed.

Thesis (Ph.D.)--The Wright Institute (Berkeley), 1981. / Includes bibliographical references.

No description available.

This qualitative study was designed to identify protective practices that mitigate risks of Vicarious Traumatization (VT) among trauma therapists. The sample included six peer-nominated experienced therapists, trained at the masters or doctoral level, who self-identified as having managed well in this work. Narrative data was collected through interviews with individual co-participants, who were asked, "How do you manage to sustain your personal and professional wellbeing, given the challenges of your work with seriously traumatized clients?" Data analysis was based upon Lieblich, Tuval-Mashiach, and Zilber's (1998) typology of narrative analysis, with a primary focus on thematic content analysis within and across participants' narratives. The research findings yielded twelve major themes that describe protective practices engaged by exemplary trauma therapists: countering isolation (in professional, personal and spiritual realms); developing mindful self awareness; consciously expanding perspective to embrace complexity; openness to the unknown; sustaining and renewing hope; active optimism and problem solving; holistic self-care; maintaining clear boundaries; invoking imagery, metaphor, and ritual; exquisite empathy; professional satisfaction; and creating meaning. The novel finding that empathic engagement with traumatized clients appeared to be protective challenges previous conceptualizations of VT and points to exciting new directions for research and theory, as well as applications to practice. Participants also described experiences of vicarious post-traumatic growth. The findings confirm and extend previous recommendations for ameliorating VT and underscore the ethical responsibility shared by employers, educators, professional bodies, and individual practitioners to create time and space to address this serious problem. Participants recommend opportunities for regular supervision, support and validation (including group-based interaction), self-care (including personal therapy, as needed), and developing self-awareness within and beyond the workplace. They think taking care of the caregivers is an organizational responsibility as well as a personal one. Although the research design precludes generalizing from the data, the knowledge generated herein may be helpful to others in the fields of psychology, psychiatry, social work, psychiatric nursing, and related health care disciplines, at the levels of education, training, and practice.

Concurrent and prospective relationships between symptoms of depression, anxiety, attention deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and academic achievement were examined in a large sample of Canadian children. Students in Grade 5 (N = 715) completed the depression and anxiety subscales of the Behaviour Assessment System for Children – Second Edition. Parents reported on their child’s symptoms of ADHD and CD using the Brief Child and Family Phone Interview. Academic achievement was measured using teacher-rated learning skills and students’ grade point average (GPA) from their Ontario Student Record (OSR) in fifth grade and again in sixth grade (N = 627). Symptoms of depression, anxiety, ADHD, and CD were significantly negatively correlated with academic achievement at Time 1 and Time 2. After controlling for child’s sex, household income, maternal education, and days absent, children’s mental health problems accounted for an additional 12% and 11% of the variability in their Time 1 mean ratings of learning skills and GPA, respectively. Only symptoms of ADHD predicted Time 2 GPA (1% of the variance) after controlling for Time 1 GPA and other sociodemographic variables. Findings highlight the unique contribution of mental health problems in predicting academic achievement and point to the need to promote children’s mental health in schools.

According to the Canadian Nurses’ Association (2005), mental health (MH) nursing is currently undervalued in the nursing profession. The Education Committee of the Canadian Federation of Mental Health Nurses (CFMHN) (2009) reports that the length of MH theory and practicum varies enormously in the undergraduate nursing programs of Ontario and across the country. Interviews with 19 nursing professors representing programs with different MH components show a variation in their opinions about topics such as the degree of importance of a mandatory stand-alone MH component, whether MH nursing education should be students’ or professors’ responsibility, how professors relate themselves to the MH component, and their familiarity with and assessment of their program’s MH education. It remains unclear the extent to which these factors contribute to program design and, in turn, students’ knowledge of MH nursing. Further research in this area is required. / UOIT

Rationale: Mental health (MH) issues are increasing on post-secondary campuses particularly with ethnic students. This study aimed to establish the effectiveness of web-based MH education. Methods: A three-phase design was used with non-random sampling. An interest questionnaire addressed students’ (n=42) interest/preferred method of MH education in the first phase. In the second phase, a pre/post knowledge test/attitude scale assessed Mindsight’s (a web-based tool for MH education) effectiveness with ethnic students from the initial sample (n=13). In the final phase, ethnic students provided feedback on Mindsight’s effectiveness during focus groups/telephone interviews. Results: Most students considered MH education important and would use web-based tools. All students showed an increase in MH knowledge and most showed a decrease in stigmatizing attitudes. Mindsight was considered easy to use and interactive, however lacked in ethnic sensitivity. Conclusion: Web-based MH education has potential; however, ethnic sensitivity needs to be addressed. / UOIT