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Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The leading reason for suicide attempts in Japan is health problems, among which depression is the most common, followed by physical illnesses.Patients with physical illness and suicide ideation are not rare among patients receiving home‐based care.General home visiting nurses (GHVNs) without knowledge, skills or experience in psychiatric care are required to provide care for patients with physical illness who are at risk of suicide in Japan. What this paper adds to existing knowledge?: More detailed understanding of GHVNs' experiences and perspectives on working with suicidal patients in home care.This study enriches our understanding of how suicide prevention strategies should be developed for GHVNs. What are the implications for practice?: Focusing education on therapeutic communication skills and meanings with relationships with patients is required by GHVNs.Training for suicide risk assessment and guidelines appropriate to GHVNs' situation is crucial.Establishing a liaison service system with a multidisciplinary team, including psychiatric home‐visiting nurses, is necessary for home healthcare to achieve continuity of care. Introduction: In Japan, even a general home visiting nurse (GHVN) lacking psychiatric experience and training can provide home nursing care to patients at risk of suicide. Little attention is given to nursing care for suicide by GHVNs who care for patients with physical illness. However, these patients with suicidal ideation for home care are surprisingly common. Aim/Question: We explored the experiences of GHVNs who cared for patients with suicidal ideation and focused on the nurses' perceptions and interactions. Method: We conducted semi‐structured interviews with 15 GHVNs. We discussed the nurses' experiences caring for patients with suicidal ideation, their perceptions during these interactions and their response. Results: General home visiting nurses were perplexed upon learning of the patient's suicidal ideation. They interacted with such patients by 'avoiding the core of the matter' while focusing on maintaining a relationship with them. Discussion: Not addressing the patient's suicidal thoughts will not only disable the suicide risk assessment but also lead to patient isolation. Suicide prevention care needs to consider the unique characteristics of home care. Implications for Practice: General home visiting nurses require training in suicide risk assessment and communication skills. Establishing a liaison service, including psychiatric home visiting nurses, is necessary to achieve continuity of care. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population.There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. What this paper adds to existing knowledge?: The present study developed the two‐factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS‐CAMHN).We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model‐fit indexes, and its good concurrent and divergent validity. What are the implications for practice?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN.The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. Introduction: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. Aim: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. Method: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self‐administered survey. The scale's construct validity, criterion‐related validity, internal consistency and test–retest reliability were assessed. Results: A two‐factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two‐factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. Discussion: The scale is reliable and valid for assessing CAMHN clinical competency. Implications for Practice: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? A lack of transitional care covering the period from psychiatric hospital discharge to community mental health care can increase the likelihood of illness recurrence or readmission of discharged patients., What this paper adds to existing knowledge? The participants expressed the view that discontinuity between inpatient and community life was a post-discharge challenge after being involuntarily admitted to a psychiatric emergency ward., These challenges arose from the dissatisfaction with inpatient treatment, inability to coordinate post-discharge life, What are the implications for practice? Patients should be able to disclose their feelings about their own experiences in inpatient care settings and the current challenges in community care settings in an open manner., An advocate should be appointed in acute psychiatric inpatient care settings to reflect patients' own feelings and individual needs to transitional care without bias to inpatient and community care providers., Abstract Introduction Psychiatric care in Japan usually comprises inpatient care provided during lengthy hospital stays. Recently, policies for shortening psychiatric hospital stays have been aggressively pursued. However, appropriate transitional care is not always provided for acute psychiatric inpatient care. Aim We elucidated patients' challenges immediately after hospital discharge following acute psychiatric inpatient care to clarify how to improve inpatient care and post-discharge follow-ups. Method This study utilized a qualitative descriptive study design and incorporated patient interviews. Participants comprised 18 patients who experienced involuntary admission following a diagnosis of schizophrenia spectrum disorder. Inductive qualitative content analysis was used to create codes and categories from interview transcripts. Findings The core category of post-discharge challenges that emerged was 'separating life as an inpatient from community life'. This comprised two subcategories: 'dissatisfaction with the inpatient care received' and 'lack of abilities to coordinate lifestyle following discharge'. Discussion Patients should be able to disclose their feelings about their experiences in inpatient care settings and the current challenges in community care settings openly. Implications for practice Advocate (e.g. peer staff) should be appointed in acute psychiatric inpatient care settings to reflect patients' feelings and individual needs to transitional care without bias to inpatient and community care providers. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Empowerment of family caregivers of adults with mental health issues has received increasing attention among mental health nurses in Japan and has been recognized as a new goal of family interventions., The Family Empowerment Scale ( FES) was originally developed to measure the empowerment status of parents of children with emotional disorders. However, it was later applied to broader health issues., What this paper adds to existing knowledge? We developed a Japanese version of the FES for family caregivers of adults with mental health issues ( FES- AMJ) and examined the validity and reliability among parents. Results showed that the FES- AMJ had acceptable concurrent validity and reliability; however, insufficient construct validity was found, especially for the subscale regarding the service system., What are the implications for practice? Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important., Abstract Introduction The Family Empowerment Scale ( FES) was originally developed for parents of children with emotional disorders. In Japan, family empowerment is gaining increasing attention and may be one goal of nursing interventions. Aim To develop a Japanese version of the FES for family caregivers of adults with mental health issues and to study the validity and reliability of this scale among parents. Method We translated the FES into Japanese and administered this self-report questionnaire to 275 parents. Results The multitrait scaling analysis revealed acceptable convergent validity and insufficient discriminant validity among all subscales. In particular, all items of the Service system subscale had insufficient discriminant and/or convergent validity. Each subscale significantly correlated with the indicator of empowerment. The intraclass correlation coefficients of each subscale were .855-.917. Cronbach's alpha of each factor ranged from .867 to .895. Discussion The Service system subscale may not linearly reflect family empowerment, and instead may depend on unclear roles of family caregivers of adults, disorder severity or insufficient services. Implications for practice Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Loneliness among people diagnosed with schizophrenia is a serious problem. Recent studies have focused on the loneliness; however, no study has examined the relationships between loneliness and both individual and environmental factors comprehensively., What this paper adds to existing knowledge? The main results indicated that the community-dwelling people diagnosed with schizophrenia in Japan as well as in other countries experienced higher levels of loneliness. Both individual and environmental factors were related to loneliness. Increasing the self-efficacy for community life and self-esteem of individual factors, and not being socially isolated and increasing community integration of environmental factors would improve their loneliness., What are the implications for practice? Health practitioners, in particular, public health nurses in mental health care, should work to develop a partnership with people diagnosed with schizophrenia, their family members, friends and other community-dwelling people in order to decrease and prevent loneliness. For individuals diagnosed with schizophrenia, interventions by cooperating with community resources and using the technique of nurses to assist them with continuous community activity could be useful. For environmental interventions, population approach such as developing daily programmes which family members can participate in, and cooperating with educational institutions and community events could have a positive effects., Abstract Introduction Loneliness among people diagnosed with schizophrenia living in communities can decrease quality of life and may contribute to suicide. Aim The aim of this study was to examine the levels of loneliness among Japanese people diagnosed with schizophrenia and to identify individual and environmental factors related to their loneliness. Method A cross-sectional survey was conducted with 264 people diagnosed with schizophrenia who use local activity support centres in urban areas. The self-administered questionnaires included questions on loneliness, demographic characteristics, individual factors including self-efficacy for community life and self-esteem, and environmental factors including social isolation, community integration and service use. Results The study results indicated that people diagnosed with schizophrenia in Japan experience higher levels of loneliness, corroborating results from other countries. Multiple regression analysis showed that a lower level of self-efficacy for community life, self-esteem, community integration and social isolation predicted a higher level of loneliness, accounting for 55.3% of variance. Implications for Practice Public health nurses in mental health care in Japan can work with individuals diagnosed with schizophrenia and communities using the technique to assist them with continuous activity and cooperating with community resources and educational institutions in order to decrease and prevent loneliness. [ABSTRACT FROM AUTHOR]