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Therapeutic relationships are critical in the treatment of mental health disorders. Some clients experiencing mental health disorders display conflict behaviour-for example, suicidal or self-harming behaviour, threats of or actual aggression, and various psychotic behaviours-which presents significant challenges for care professionals. In inpatient mental health units, where interactions with mental health nurses are frequent, managing conflict behaviour is crucial to maintaining care quality and fostering therapeutic progress. This study aims to describe nurses' perspectives on fostering therapeutic relationships while working with clients who display conflict behaviour. Qualitative research was conducted in a specialised treatment setting for such clients by means of individual semi-structured interviews and a focus group interview with nurses. The results show that the nurses' primary focus is on cooperating with clients and colleagues. Regardless of conflict behaviour, nurses consistently invite clients to cooperate. To do so, they must manage their own emotions and expectations, emphasise the clients' responsibility and reduce the opportunities for conflict behaviour. The unit structure helps nurses by reducing ambiguity regarding treatment policies and inconsistencies in nurse-client interactions and allows nurses and clients to experience feelings of safety. To work with conflict behaviour, nurses need to feel valued and supported by their colleagues and have adequate time and resources. In conclusion, this study shows how nurses foster therapeutic relationships with clients who display conflict behaviour by focusing on cooperation, structure and safety., (© 2024 John Wiley & Sons Australia, Ltd.)

In mental healthcare, therapists' empathy and mentalizing are associated with better opportunities to establish positive working relations with patients. The present study aimed to explore mental health nurses' level of empathy and mentalizing (compared with reference groups studying or working in different contexts), the association between mental health nurses' level of empathy and mentalizing and sociodemographic characteristics of these nurses, and the association between mental health nurses' level of empathy and mentalizing. A cross-sectional design was used in adherence with the Strengthening the Reporting of Observational Studies in Epidemiology statement. The 28-item Empathy Quotient was used to investigate empathy, and the 28-item Mentalisation Scale was used to assess mentalizing. One hundred and seven mental health nurses working in different work-intensity settings (intensive and intermittent-intensive) participated in the study. Our analyses showed that mental health nurses had statistically significantly higher levels of empathy and mentalizing than the matched reference groups. They also showed that most mental health nurses' demographic characteristics were not statistically significantly associated with their level of empathy and mentalizing: not with age, years of work experience, or educational level. Only two aspects were statistically significantly associated: female gender (for higher levels of empathy and mentalizing) and practicing in an intermittent-intensive work setting (for higher scores on the subscale 'Motivation' of the Mentalisation Scale). Furthermore, empathy and mentalizing of mental health nurses were strongly associated and also emerged as two partly overlapping concepts. We conclude that mental health educational institutions and supervisors could pay extra attention to the aspects of gender and work situation concerning mental health nurses' mentalizing and empathy in patient relations., (© 2025 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

The objective was to use various somatic parameters as basis for investigating the physical health of older adults with severe mental illnesses (SMI). A cross-sectional study design is performed by using baseline data from the Physical Health in SMI-elderly (PHiSMI-E) study. Data were collected using the Nursing Monitoring of Somatic Status and Lifestyle - Mental Health instrument in adults aged over 60 with SMI in a large Dutch mental health institute. Ninety-nine elderly SMI patients were included. Somatic comorbidity (84.8%), use of somatic medication (77.7%) and polypharmacy (67.7%) were prevalent. Extrapyramidal symptoms were experienced by 51% of patients, mainly in the subgroup with psychotic disorders (75.6%). Unhealthy diet was reported in 16.2%, obesity in 27.3%, and physical inactivity in 57.6%. Fatigue (67.7%) and dry mouth (66.6%) were the commonest reported physical symptoms. Mean VAS score (scale 0-10) indicating participants' self-perceived physical health was 6.7 (SD ± 1.6). After division of the total patient group into tertiles based on the VAS scores, the lowest tertile was characterized by less physical activity, unhealthier diet, more use of medication, more fatigue, somnolence, and inner agitation. In conclusion, impaired physical health status was common in these older patients with SMI. Although they had more psychiatric and somatic comorbidity than adult SMI patients described in the literature, they had a healthier lifestyle. To reduce morbidity and premature mortality in these frail patients, it is essential that healthcare providers are aware of the high prevalence of somatic comorbidity and symptoms, and of their interactions with the psychiatric disorders. This study improves our understanding of differences in vulnerability factors of older patients with SMI. The (early) detection of somatic comorbidities may improve long-term health outcomes of these patients., (© 2018 Australian College of Mental Health Nurses Inc.)

An important part of inpatient treatment for adolescents with anorexia nervosa is to restore normal eating behaviour. Health-care professionals play a significant role in this process, but little is known about their interventions during patients' meals. The purpose of the present study was to describe nursing interventions aimed at restoring normal eating behaviour in patients with anorexia nervosa. The main research question was: 'Which interventions aimed at restoring normal eating behaviour do health-care professionals in a specialist eating disorder centre use during meal times for adolescents diagnosed with anorexia nervosa? The present study was a qualitative, descriptive study that used video recordings made during mealtimes. Thematic data analysis was applied. Four categories of interventions emerged from the data: (i) monitoring and instructing; (ii) encouraging and motivating; (iii) supporting and understanding; and (iv) educating. The data revealed a directive attitude aimed at promoting behavioural change, but always in combination with empathy and understanding. In the first stage of clinical treatment, health-care professionals focus primarily on changing patients' eating behaviour. However, they also address the psychosocial needs that become visible in patients as they struggle to restore normal eating behaviour. The findings of the present study can be used to assist health-care professionals, and improve multidisciplinary guidelines and health-care professionals' training programmes., (© 2015 Australian College of Mental Health Nurses Inc.)

The attitude of nurses and treatment staff is crucial in the treatment of patients who self-harm. However, many patients experience that attitude as negative. The aim of this study was to investigate the psychometric properties of the Dutch version of the Attitude Towards Deliberate Self-Harm Questionnaire. A total of 261 questionnaires were used to measure validity and reliability. Sensitivity to change was measured using a post-test measurement (n = 171) and a subgroup of 78 participants were given the questionnaire twice for test-retest measurement. Factor analysis revealed four factors explaining 33% of the variance. Cronbach's alpha values ranged 0.585-0.809, with 0.637 for the total scale. Intraclass correlation coefficient was assessed in order to estimate test-retest reliability, revealing the questionnaire was stable over time; the exception was factor 3, which had a value of 0.63. Sensitivity to change was found for the total score, factor one and two, and for three of the five items of factor three. We conclude that the Dutch version of the Attitude Towards Deliberate Self-Harm Questionnaire possesses adequate psychometric properties and is potentially an acceptable instrument for measuring the attitude of nurses and health-care staff towards patients who self-harm in Dutch-speaking countries., (© 2015 Australian College of Mental Health Nurses Inc.)

This article reviews and discusses the literature on the recognition of the early warning signs of psychosis. The assumption is that nurses, in the everyday exercise of their profession, can contribute to the prevention of psychotic relapse in schizophrenic patients by the early recognition of warning signs. First, the process of psychotic relapse and the factors that influence it are described. Then research on the early signs of psychosis is discussed. This article questions the most common early signs, when they occur, and who can recognize them. Then the predictive value of the early signs is considered: how well can psychotic relapse be predicted with these early signs? Finally, the research on the effects of early recognition and early intervention is discussed, primarily with respect to the question of whether psychotic relapses can actually be prevented by making use of preventive intervention strategies. The conclusion is that the preliminary results are hopeful and invite further research on such matters as the application of this intervention strategy within nursing practice.