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Aim: To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long‐standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. Design: Discursive Paper. Method: Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. Discussion: Evidence‐based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American populations. Conclusion: Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. Impact to Nursing Practice: Nurses play an integral role in providing holistic quality patient‐centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self‐awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. No Patient or Public Contribution: There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion. [ABSTRACT FROM AUTHOR]

Aim. This article discusses the clinical implications of adverse health outcomes derived during heatwaves for people with mental health disorders, substance misuse and those taking prescribed medications such as lithium, various neuroleptic and anticholinergic drugs. Background. With climate change it is predicted that the incidence of prolonged periods of extreme heat will increase. Specific adverse health outcomes associated with high environmental temperatures include heat stroke and heat exhaustion. Those at increased risk for heat-related mortality are those with chronic health conditions, including those with mental health disorders and substance misuse. Data sources. Sources of evidence included and 'grey' literature published between 1985 and 2010, such as key texts, empirical research, public policies, training manuals and community information sheets on heat waves. Discussion. Current clinical practice and clinical impact of heatwaves on those people with comorbidity is explored. This includes the physiological components of heat stress, heat regulation, and the impact of alcohol and other drugs; and, ramifications and professional practice issues for those with mental health conditions and those requiring mental health medications. Implications for nursing. Client education covering modification of the environment and the use of client heat safety action plans. Secure, accessible stores of prescribed medication are recommended and emergency substance withdrawal kits could be made available. Conclusion. All nurses have a responsibility to increase the capability and resilience of their clients to manage their chronic health needs during a heatwave. At these times nurses need to give extra monitoring and assistance when clients lack the capacity or resources to protect themselves. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To identify and synthesize evidence on the use of action research methods in mental health nursing care. Design: Systematic review. Data Sources: CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021. Review Methods: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta‐Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures. Results: Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person‐centred approach to care and improving decision‐making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment. Conclusion: This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels. Impact This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person‐centred approach to care and decision‐making procedures. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: The aim of this study was to explore the impact of the pandemic on the emotional and mental well‐being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. Design Longitudinal, qualitative semi‐structured interview study. Methods: Remote semi‐structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow‐up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. Results: In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and residents, has been negatively affected, and relationships between family carers and staff have been severely strained. There was a general lack of adequate mental health support, with little relief. Conclusions: The pandemic has had a detrimental impact on the lives of those surrounding care homes—from residents and staff to family carers. Consideration should be given on how to best support the mental health needs of all three groups, by providing adequate easily accessible mental health care for all. This should also focus on rebuilding the relationships between family carers and care home staff. Impact This is the first paper to highlight the effects of the long‐lasting and miscommunicated restrictions on residents, carers and care home staff, and highlight the urgent need for continued mental health support. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation. Design: A scoping review was performed. Data Sources: A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar. Review Methods: Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes. Results: Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention. Conclusion: The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions. Impact: With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is compounding the distress of millions of refugees (made up of displaced persons, forced migrants, refugees and asylum seekers) throughout the world. This discursive paper pitches a challenge for the global nursing profession, within the multidisciplinary context, to consider its collective agency in responding to the health and well-being needs of a priority portion of the global population. Nursing leaders are encouraged to renew their commitment to the International Council of Nurses' Code of Ethics and consider the role of their profession in assisting global refugees, because the extent of present need has become an escalating major global humanitarian crisis. The nursing profession comprises half the world's healthcare workforce. The World Health Organization considers that nurses play a fundamental role in ensuring access to universal healthcare as a basic human right, addressing the global need for health promotion care, disease prevention and primary and community healthcare (International Council of Nurses, The ICN code of ethics for nurses; 2012). It is a human right to seek asylum from persecution, and in doing so, people should not be subjected to cruel, inhumane or degrading treatment or circumstances. Nurses are increasingly interested in fostering a healthy and adaptive environment in which people can thrive, despite personal, political, emotional, physical or social adversity. Nursing care is indispensable for the easement of human distress and for the promotion of comfort and coping. Nurses have an essential role in advocating for policies that will enhance immigrants' access to health/mental health services and address barriers irrespective of migrant/refugee/asylum seeker status. These are challenging times as the world responds to the pandemic crisis, and nurses are called to rise to global and local leadership roles and join with other health and social care colleagues in addressing the universal human health, social and political crisis of our time. The global nursing collective must come to terms with the need to initiate additional compelling ways to improve and integrate health and social care processes so that nursing care, mental health and social care augment a holistic achievement of appropriate care for refugees. [ABSTRACT FROM AUTHOR]

Aims To explore responses to indirect trauma reported by health professionals and to identify issues of potential salience for midwives. Background Indirect exposure to a traumatic event can lead to the development of distressing and potentially enduring responses. Little is understood about the impact that perinatal trauma exposure could have on midwives. Design An integrative review design was used. Data sources PsychInfo, Medline, PsychArticles, Web of Knowledge, CINAHL, MIDIRS and Scopus databases were search for papers published between 1980-November 2012. Review methods Studies providing quantitative or qualitative exploration of healthcare professionals' responses to indirectly experienced traumatic events were selected. Results Forty-two papers fulfilled the inclusion criteria. Four of these studies included professionals engaged in maternity care or exposed to traumatic perinatal events. Findings indicate evidence of intrusion, avoidance and arousal in healthcare professionals, with differing degrees of frequency. Empathy, work-related stress and the extent of professional experience were identified as associated with traumatic stress responses. Conclusions Evidence derived from healthcare professionals suggests that indirect exposure to the traumatic events of recipients of care can sometimes elicit traumatic stress responses. Factors increasing risk for traumatic stress were identified as empathy and organizational stress. These factors hold specific salience in midwifery. Responding to trauma in a midwifery context, as informed by findings from other healthcare professionals, could adversely affect midwives' well-being, care provided to women and contribute to an adverse organizational climate. Large-scale research considering the experiences of midwives is recommended. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

yearwood e. & riley j.b. (2010) Curriculum infusion to promote nursing student well-being. Journal of Advanced Nursing 66(6), 1356–1364. Title. Curriculum infusion to promote nursing student well-being. Aim. This paper is a report of a study of baccalaureate nursing students’ experiences with curriculum infusion of college health issues into academic courses and students’ well-being. Background. Bringing Theory to Practice is an ongoing project at a number of colleges in the United States of America. Its goal is to use the academic classroom and campus community to engage students actively in self-reflection on a variety of common college student health and well-being issues. Method. This qualitative study was based on 159 students’ experiences with curriculum infusion in two undergraduate nursing courses at a university in the United States of America over a 2-year period from 2006 to 2008. Student reflection papers, photo-essays, narrative course evaluations, classroom engagement with educators and peers and student use of campus health resources were the data examined. Findings. As a result of the integration of personal wellness concepts into classroom pedagogy, students experienced a variety of feelings and needs including isolation, shock and anger, taking time, awareness and valuing. Conclusion. In light of the increasing rigour of baccalaureate nursing programmes, it is important for educators to be aware of the health-related effects of stress and isolation on students. By increasing student self-awareness and changing relational dynamics in the classroom, student well-being can be supported. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how immigrant women and men from India construct mental health and mental illness in the perinatal period. Design: Qualitative interpretive design. Methods: Data were collected by conducting in‐depth interviews with 19 participants. Photo elicitation, free listing and pile sorting were used during the interviews. Purposive sampling was used, and data were collected in 2018 and 2019. Data were analysed using thematic analysis. Finding/Results: One major theme and three subthemes were identified. 'We do not talk about it' was the major theme and the subthemes: (1) 'living peacefully and feeling happy' described the views on mental health; (2) 'that's the elephant in the room still' captures how participants felt when talking about mental illness; and (3) 'why don't we talk about it' offers reasons why the Indian community does not talk about mental health and illness. Conclusion: The findings of this study have highlighted the importance of understanding the impact of immigration and being culturally sensitive when assessing mental health in the perinatal period. Impact: The findings of this study identify some of the reasons for non‐disclosure of mental health issues by immigrants. Incorporating these findings during psychosocial assessment by health professionals in the perinatal period will help translate the cultural aspects into more effective communication. Patient or Public Contribution: Patient and public contribution to the study was provided by the Community Stakeholders Group; these were members of the immigrant community from India who had expertise in mental health. They contributed to the study design and the key terms and phrases for the free list used in interviews. [ABSTRACT FROM AUTHOR]

Aim: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID‐19 pandemic. Design: A secondary analysis of open‐ended responses from a cross‐sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID‐19 pandemic. Methods: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open‐ended responses. Results: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post‐traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense‐ of‐duty and (4) personal strength from new possibilities. Conclusion: The COVID‐19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. Implications for the Profession and/or Patient Care: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision‐making transparency are necessary. Impact: To better understand how frontline acute care nurses experienced stress during COVID‐19, a data‐informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post‐traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post‐traumatic growth in the post‐COVID years. Reporting Method: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide. Design: Systematic review with a data‐based convergent synthesis. Data Sources: MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included. Methods: Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty‐one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis. Results: Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported. Conclusion: Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts. Implications: Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved. Impact: Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers. Patient or Public Contribution: There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: This study examined the experiences of Syrian refugees in a community centre in Turkiye as they access mental health services and receive psychiatric nursing care. Design: A qualitative design was adopted in the study. Methods: Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semi-structured focus group interviews. Colaizzi's phenomenological method was followed to analyse the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews. Results: Three key themes related to immigrants' experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care. Conclusions: This study determined that Syrian refugees face barriers in accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. Impact: Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centres, must facilitate the processes to eliminate these obstacles. Reporting Method: The consolidated criteria for reporting qualitative research (COREQ) were used. [ABSTRACT FROM AUTHOR]

Aim: To examine the mental health conditions of family caregivers residing away from their loved ones who experienced visitation restrictions during the coronavirus disease 2019 pandemic. Design: A mixed-methods design applying the Kessler Scale-10 for the quantitative measurement of psychological distress and an open-ended question for qualitative analysis. Methods: The participants were recruited from care facilities between February and September 2021. This cross-sectional study included 197 family caregivers who were utilizing formal residential care services for their loved ones. Using thematic analyses, open-ended responses regarding the impact of visitation restrictions were coded. These themes were then examined to determine thematic patterns across caregiver characteristics. Results: Thirteen themes were identified regarding the impact of visitation restrictions. Many participants reported primary harmful effects as follows: ‘inability to confirm the type of care and lifestyle assistance provided to an older relative’ and ‘difficulty communicating with an older relative because of the inability to converse face-to-face’. Younger age, being employed, poor sleep, poor relationship quality with the care recipient and experiencing harmful effects from the visitation restrictions were associated with psychological distress. Conclusion: Our findings suggest that to maintain positive mental health after a care transition, it is important for family caregivers to take part in the care of their loved ones and ensure information sharing between the care recipient's family and institution. Impact: These findings suggest that both residents and family caregivers living outside facilities may feel distressed due to separation. Therefore, institutional care staff needs to consider how to adjust facility procedures or communication with family caregivers. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity. Design: A cross-sectional design with a convenience sample. Methods: A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study. Results: The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity. Conclusion: Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload. Impact: Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. Design: Cross-sectional survey conducted January to April 2020. Methods: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. Results: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. Conclusions: Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. Impact: This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers' quality of life. Background: Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. Design: An interpretive descriptive approach that incorporated the photovoice method was used. Methods: Using a purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a 4-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analysed using thematic analysis with an inductive approach. Findings: Caregivers expressed feelings of frustration, confusion and joy. Emerging themes included: (i) feeling like a 'criminal' amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories. Conclusions: The combination of visual and textual methods provided unique insight into the mental distress, isolation and intense emotional burdens experienced by caregivers during the pandemic. Impact: Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support the mental health of caregivers. Reporting Method: This work adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Public Contributions: The caregivers included in the study were involved in the cocreative process as active contributors informing the design and validation of the codes and themes. [ABSTRACT FROM AUTHOR]

Aim To report findings of a systematic review and meta-synthesis of qualitative studies exploring public health nurses' perceptions and experiences of identifying and managing women with perinatal mental health (PMH) problems. Background Public health nurses play a key role in supporting women who experience PMH problems and several qualitative studies have explored their role. Design Systematic review and meta-synthesis Data sources A comprehensive search was developed and multiple databases were searched from 2000-2015. Review methods Studies that employed qualitative methods to explore experiences of public health nurses in identifying and managing women with PMH problems were included. Two reviewers independently assessed the methodological quality of studies. Themes, concepts and interpretations were extracted and synthesized using the process of thematic analysis. Results Fifteen papers including 14 unique qualitative studies were included. Two overarching themes were identified: 'conceptualization and detection of PMH problems' and 'barriers and facilitators to management'. The former of these comprised several subthemes including the use of formal screening tools vs. clinical intuition and challenges encountered in detection. The latter theme, barriers to management included availability of referral pathways and time. In terms of facilitators, training, public health nursing interventions, support groups and referral pathways were identified as factors that optimize management. Conclusions Public health nurses use a variety of methods to identify women with PMH problems. However, several support structures are needed to optimize management including access to appropriate referral pathways, support groups and relationship continuity. [ABSTRACT FROM AUTHOR]

Aim: To understand the experience of critical care nurses during the COVID‐19 pandemic, through the application of the Job‐Demand‐Resource model of occupational stress. Design: Qualitative interview study. Methods: Twenty‐eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID‐19 pandemic took part in semi‐structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job‐Demand Resource model. Data were analysed using framework analysis. Results: The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post‐traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well‐being had negative organizational consequences with CCN expressing increased intention to leave their role. Conclusions: The combination of high demands and reduced resources had negative impacts on the psychological well‐being of nurses which is translating into increased consideration of leaving their profession. Implications for the Profession and/or Patient Care: The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Impact: Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. Reporting Method: We used the COREQ guidelines for reporting qualitative studies. Patient and Public Contribution: Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic. [ABSTRACT FROM AUTHOR]

Aim. This study explores the experience of the diagnosis of Multiple Sclerosis for the support person and identifies the impact on their lives. Background. At the time of diagnosis, the support person may not be readily identified in a traditional caring role; however, the diagnosis itself brings with it the possibility of changes to the roles in the relationship and possible consequences for biographical construction. Design. A hermeneutic phenomenological study. Methods. A convenience sample of nine support persons was interviewed between December 2008 - March 2010. The data were analysed using interpretative phenomenological analysis. Findings. The participants in this study were often not readily identifiable as 'carers'; however, the diagnosis of Multiple Sclerosis implied a shift towards a caring role at some point in the future. The uncertainty surrounding the nature and progression of the condition left this identity hanging, incomplete and as such contributed to a liminal way of being. Conclusions. This paper reveals that biographical disruption is not limited to the person diagnosed with Multiple Sclerosis but that the support person also undergoes a transition to their sense of self to that of 'anticipatory carer'. The findings provide insight into the biographical and emotional impact of Multiple Sclerosis on the support persons early in the development of the condition. [ABSTRACT FROM AUTHOR]

Aims: Clique percolation, one of the joint community detection algorithms in network science, is a novel and efficient approach to detecting overlapping communities in real networks. The current study illustrated how clique percolation can help to identify overlapping communities within the complex networks underlying health disparities, particularly highlighting nodes with strong associations with more than one community. Design: A cross‐sectional study. Methods: The study used a dataset on Latinx populations (N = 1654; mean age = 43.3 years; 53.1% women) as an example to demonstrate the role of such overlapping nodes in the network of syndemic conditions and their common risk factors. Syndemic conditions in the network included HIV risk, substance abuse (smoking, heavy alcohol consumption and marijuana use) and poor mental health. Moreover, the risk factors encompassed individual (education and income) and sociostructural (adverse childhood experiences [ACEs] and access to services) factors. The network was estimated using the R‐package bootnet. Clique percolation was conducted on the estimated network using the R‐package CliquePercolation. Results: A total of three communities were detected, with HIV risk and poor mental health not being assigned to any community. In general, Community 1 was comprised of ACE categories, Community 2 included education, income and access to services and Community 3 included other syndemic conditions. Of note, two nodes were assigned to two communities: 'household dysfunction' to Communities 1 and 2 and 'smoking' to Communities 2 and 3. Conclusion: Household dysfunction might be the key connector, among other ACEs, to individual and structural barriers. Such barriers further exposed Latinx individuals to risky behaviours, especially smoking, which further linked to marijuana use and heavy alcohol consumption. Impact: Clique percolation facilitated our understanding of the complex systems of factors shaping health disparities. The overlapping nodes are promising intervention targets for reducing health disparities in this historically marginalized population. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore the associations between social determinants of health and patient‐centred outcomes among adults with chronic heart failure with reduced ejection fraction. Design: Cross‐sectional online self‐report survey. Methods: A survey assessing social determinants of health (demographics, socio‐economic position, affordability of care and social support) and patient‐centred outcomes, including the Kansas City Cardiomyopathy Questionnaire‐12 and validated measures of medication adherence, treatment satisfaction, treatment burden and mental health, was completed by 512 adults with chronic heart failure with a reduced ejection fraction between 06 March and 29 June 2020. Multivariable analyses included linear and logistic regression. Results: Female gender, having a care partner, and being offered financial assistance with medications were associated with worse health status, while perceiving medication as affordable and being married were associated with better health status. Females and having Medicaid, dual Medicaid/Medicare or no medical insurance were associated with a higher likelihood of depression, and non‐white race/ethnicity was associated with less depression. Medication adherence was lower in patients having a care partner and offered financial assistance. Patients being offered financial and medication management assistance were more likely to be overwhelmed by the treatment burden, whereas those having some college education were less so. Conclusions: Social determinants of health are associated with patients' disease‐specific health status, mental health and treatment satisfaction and burden. These findings underscore the importance of assessing social determinants of health in clinical practice and the need for developing and testing novel strategies to determine whether they improve patients' health. Impact: The relationship between social determinants of health‐ and patient‐centred outcomes was assessed; affordability of care and social support factors were most strongly associated with outcomes for patients with chronic heart failure and reduced ejection fraction, underscoring the importance of assessing social determinants of health in routine clinical care. Implications for the profession and/or patient care: Social determinants of health data could potentially inform care delivery for patients with heart failure and reduced ejection fraction by helping to identify those who require additional support to manage their symptoms, access care and adhere to treatment. Social support and affordability of treatment were associated with most patient‐centred outcomes, suggesting these factors may provide clinicians with an indicator of a patient's level of general well‐being that could be assessed during routine follow‐up care. Reporting method: This research followed the STROBE checklist for cross‐sectional studies. Patient or public contribution: Adults who have heart failure with reduced ejection fraction that consented to participate in the study provided the data used for all analyses reported on in the manuscript. Service users, caregivers or members of the public had no involvement in the study. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore nurses' experiences of seclusion or restraint use and their participation in immediate staff debriefing in inpatient mental health settings. Design: This research was conducted using a descriptive exploratory design and data were gathered through in‐depth individual interviews. Methods: The experiences of nurses following seclusion or restraint use and their participation in immediate staff debriefing were explored via teleconference, using a semi‐structured interview guide. Reflexive thematic analysis was used to identify prevalent themes from the data. Results: Interviews (n=10) were conducted with nurses from inpatient mental health wards in July 2020. Five themes emerged through the data analysis: (i) ensuring personal safety; (ii) grappling between the use of least‐restrictive interventions and seclusion or restraint use; (iii) navigating ethical issues and personal reactions; (iv) seeking validation from colleagues and (v) attending staff debriefing based on previous experience. The themes were also analysed using Lazarus and Folkman's Transactional Model of Stress and Coping. Conclusion: Staff debriefing is a vital resource for nurses to provide and/or receive emotion‐ and problem‐focused coping strategies. Mental health institutions should strive to establish supportive working environments and develop interventions based on the unique needs of nurses and the stressors they experience following seclusion or restraint use. Patient or Public Contribution: Nurses in both frontline and leadership roles were involved in the development and pilot test of the interview guide. The nurses who participated in the study were asked if they can be recontacted if clarification is needed during interview transcription or data analysis. [ABSTRACT FROM AUTHOR]

Background: Racism is a social determinant of health that links to the health and well‐being of racial/ethnic marginalized populations. However, perceived racism among African Canadian adolescents has not been adequately addressed, especially the link between racism and psychosocial stressors in school settings. Aim: The aim of the current study was to assess racism and the link to school‐related psychosocial stressors in a population‐based sample of African Canadian adolescents. Design: Secondary analysis of the population‐based 2018 British Columbia Adolescent Health Survey dataset. Methods: Logistic regression and generalized linear models tested the link between racism and psychosocial stressors among African Canadian adolescents (n = 942), adjusting for sociodemographic factors. Results/Findings: More than 38% of the adolescents reported racism in the year preceding the survey. Regardless of gender and birthplace, and controlling for covariates, those who experienced racism were significantly more likely to report peer victimization, which includes teasing, social exclusion, cyberbullying and sexual harassment, and they felt less safe and connected to their schools compared to those who did not experience racism. With gender and birthplace differences, those who reported racism had higher odds of having been physically assaulted, stayed away from school, reported negative emotional responses and used avoidant behaviours to evade racism. Conclusion: African Canadian adolescents are a visible racialized ethnic group in British Columbia, who are at heightened risk of racism and the associated psychosocial stressors. Impact: These findings demonstrate the influences of racism on psychosocial stressors and related emotional responses among African Canadian adolescents. Nurses and other healthcare providers should be cognizant of racism and the psychological impacts when providing care to "at‐risk" populations. Promoting positive and inclusive school climates and addressing racism at all levels of the society will foster better social integration, as well as improve the health and academic achievement of African Canadian adolescents. Patient or Public Contribution: We presented the research and preliminary results of the data analysis to the African community (parents and adolescents who self‐identify as African). The African community who attended the gathering corroborated the link between racism and health and reiterated that addressing these psychosocial stressors can promote adolescent health and well‐being. The attendees accepted all the variables that we included in the analysis. However, they emphasized the need for more African representation among school staff and teachers to foster trust, feelings of safety and connectedness, and to promote African students' academic achievement and well‐being. They stressed the need to train and build the capacities of the school staff and teachers so that they can assist students regardless of race. They emphasized the need to promote cultural awareness and cultural sensitivity among all healthcare providers. We included the recommendations in the appropriate sections of the manuscript. [ABSTRACT FROM AUTHOR]

Aim: To understand the postpartum care received by birthing people with disabilities and their newborns, from their own perspectives. Design: A qualitative study with semi‐structured interviews. Methods: Between July 2019 and February 2020, in‐person and virtual interviews were conducted with 31 people with physical, sensory, and intellectual/developmental disabilities in Ontario, Canada, about the formal inpatient and outpatient services and supports they used in the first few months after they gave birth. Thematic analysis was used identify common themes. Results: We identified three overall themes concerning participants' postpartum care experiences and the different types of formal services received in and out of hospital: (1) lack of adequate care, (2) lack of provider awareness of disability and disability accommodations, and (3) fear of judgement, discrimination, and intrusive surveillance. The identified themes were applicable across disability groups. However, most comments on disability accommodations came from participants with physical or sensory disabilities, while participants with intellectual/developmental disabilities most commonly reported concerns about lack of adequate care and fear of judgement, discrimination, and intrusive surveillance. Conclusion: Findings indicate that postpartum care often fails people with disabilities. This could contribute to negative health consequences for them and their newborns. Impact: Birthing people with disabilities need multidisciplinary, proactive, and strengths‐based postpartum care to mitigate risk for health complications. Further, disability‐related training and guidelines for health and social service providers is required. Reporting method: Consolidated criteria for reporting qualitative research (COREQ). Patient or Public contribution: Our research team included two peer researchers with physical disabilities who served as co‐interviewers and participated in data analysis, contributing their lived experience of disability and interactions with the health care system. All stages of the study were also informed by feedback from the study's Advisory Committee, which comprised women with disabilities (many of whom are parents), disability organization staff, clinicians, and policy representatives. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of the study of nurses' attitudes to the use of seclusion. More specifically, the aim was to address the relationship between burnout, job satisfaction and therapeutic optimism and justification of the use of seclusion. Background. Research findings demonstrate that nurses continue to view seclusion as a necessary intervention. Factors that might be associated with attitudes have not been examined. Methods. Questionnaires were distributed to nurses employed in inpatient units across eight mental health services in Queensland in 2008. Heyman Attitudes to Seclusion Survey, Elsom Therapeutic Optimism Scale, Maslach's Burnout Inventory and Minnesota Satisfaction Questionnaires were completed (N = 123). Data analysis involved descriptive statistics and Pearson product-moment correlation coefficients. Results. Most participants considered certain behaviours particularly those involving harm to self, others or to property as appropriate reasons for the use of seclusion and were consistent with their perceptions of the likely practice on their unit. An association was found between therapeutic optimism and emotional exhaustion (burnout) and justifications for the use of seclusion. Participants with higher optimism scores and lower scores for emotional exhaustion were significantly less likely to support the use of seclusion in specific situations. Conclusions. The relationship between therapeutic optimism and emotional exhaustion gives new information that might influence strategies and approaches taken with the aim of reducing seclusion use. Further research is warranted to explore these relationships and their implications. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an exploration of the effects of self-efficacy and different dimensions of self-management on quality of life among kidney transplant recipients. Background. Self-efficacy is an important factor influencing self-management. Patients with higher self-efficacy have better self-management and experience better quality of life. Self-efficacy influences the long-term medication-taking behaviour of kidney transplant recipients. Method. A longitudinal, correlational design was used. Data were collected during 2005–2006 with 150 adult kidney transplant recipients on self-efficacy, self-management and quality of life using a self-efficacy scale, self-management scale and the Medical Outcomes Scale SF-36 (Chinese), respectively. Relationships among variables were analysed by path analysis. Results. Participants with higher self-efficacy scored significantly higher on the problem-solving ( β = 0·51), patient–provider partnership ( β = 0·44) and self-care behaviour ( β = 0·55) dimensions of self-management. Self-efficacy directly influenced self-care behaviour and indirectly affected the mental health component of quality of life (total effect = 0·14). Problem-solving and partnership did not statistically significantly affect quality of life. Neither self-efficacy nor self-management had any effect on the physical health component of quality of life. Conclusion. Transplant care teams should incorporate strategies that enhance self-efficacy, as proposed by social cognitive theory, into their care programmes for kidney transplant recipients. Interventions to maintain and improve patients’ self-care behaviour should continue to be emphasized and facilitated. Support to enhance patients’ problem-solving skills and the partnership of patients with health professionals is needed. [ABSTRACT FROM AUTHOR]

Aims: To explore Swedish adolescents' conceptual views of mental health and mental health problems. Design: A qualitative descriptive study design. Methods: Semi‐structured focus group interviews and individual interviews were conducted with, in total, 32 Swedish adolescents (15–18 years old) in October–November 2020. Data were analysed using systematic text condensation. Results: Three themes were identified through the analysis: Mental health is about how we feel; One's mental health depends on one's situation, thoughts and ways of coping; and Mental health problems should be taken seriously and can get severe. Conclusion: The results indicate that adolescents understand the complexity and holistic nature of mental health and mental health problems. According to the participating adolescents, positive mental health and mental health problems should be considered simultaneously to understand a young person's mental health state. Good health was described as having both absence of mental health problems and high levels of well‐being: feeling well. Mental health problems were defined as something other than normal difficulties in life, but ranging from minor difficulties to more severe conditions. However, all kinds of mental health problems were termed as feeling unwell. The results suggest that adolescents are in need of support to cope with normal difficulties in life rather than lectures about life sometimes being challenging. In addition, the results highlight the need to prevent school‐related stress and offer adolescents support for minor mental health problems. Impact The findings have implications for nurses and other professionals who encounter adolescents in their profession, for example specialist nurses, school nurses and public health professionals. The findings add knowledge that could be useful for communication with adolescents about their mental health and methods to assess their mental health status. Patient or Public Contribution: The preliminary results were presented to three classes, in year nine in lower secondary school, for validation. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the features of depressive and anxiety symptoms and illness perception and their associations in patients with acute coronary syndrome (ACS). Design: Secondary analysis of data from a cross‐sectional study and baseline data from a randomized controlled trial. Methods: From June to July 2019 and June to September 2020, patients with ACS in four public hospitals in China completed measurements of depressive and anxiety symptoms, illness perception, and sociodemographic and clinical characteristics. Data were analysed using univariate and multiple logistic regression analyses. Results: This study included 510 participants (mean age, 61.0 ± 9.9 years; 67.8% male). The prevalence of depressive and anxiety symptoms was 66.3% and 56.5%, respectively. Total score of illness perception was 43.5 ± 9.1 and mean scores of each dimension ranged from 5.5 to 7.6, suggesting relatively negative illness perceptions. The top two perceived causes of illness were negative emotions or stress (27.3%) and dietary habits (25.5%) and 24.7% of participants were unaware of causes regarding their illness. After adjusting for potential confounders, a one‐point increase in scores on illness perception regarding consequences and emotional response (range, 0–10) was related to a 22% increased probability of depressive symptoms. Every one‐point increase in scores on illness perception related to emotional response, personal control and illness comprehensibility was associated with a 38% increased, 13% decreased and 9% decreased probability of anxiety symptoms, respectively. Conclusion: Depressive and anxiety symptoms are prevalent at high rates in patients with ACS. They have a relatively negative illness perception that is associated with the prevalence of depressive and anxiety symptoms. Impact This study highlights the importance of screening for depressive and anxiety symptoms in patients with ACS, especially for those with negative illness perceptions. Targeted strategies are imperative to improve patients' health outcomes. No Patient or Public Contribution: These details do not apply to this work. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to explore the link of strength use with job burnout and investigate the role of psychological capital in the strength use–job burnout relationship among Chinese workers at the Centers for Disease Control and Prevention. Design: A descriptive, cross‐sectional design. Method: This study was conducted from September to October 2020. A total of 351 employees working at Centers for Disease Control and Prevention from five cities in China completed a series of valid and reliable instruments, namely, Strengths Use Questionnaire, Positive Psychological Capital Questionnaire and Job Burnout Questionnaire. The PROCESS macro was used to test our hypotheses. Results: We found that people with higher strength use had lower job burnout compared with those with lower levels of strength use. Furthermore, resilience and hope acted as mediators of the relationship between strength use and job burnout. Moreover, resilience and hope played equally important roles in the strength use–job burnout relationship. Conclusion: Resilience and hope mediate the association of strength use with job burnout in workers of Chinese Centers for Disease Control and Prevention. Impact Health authorities can alleviate employees' job burnout by encouraging strength use and building their psychological capital, especially resilience and hope. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationships between challenges, coping and resilience among immigrant parents caring for their children with disabilities; and to explore their coping and resilient experiences and the service centre providers' perspectives on these. Design: A sequential explanatory mixed methods study. Methods: The participants were recruited from seven centres of disability service in Australia between May 2019 and February 2020. Phase 1 consisted of a cross‐sectional survey. Data were collected from 134 immigrant parents. Phase 2 consisted of semi‐structured interviews. Data were collected from nine immigrant parents and nine service providers. The findings from each phase were analysed separately and then integrated to answer the research aims. Results: Immigrant parents experienced challenges such as overwhelming caretaking responsibilities, lack of supportive social networks and feeling embarrassment over their children's behaviours. They used a variety of coping strategies, including reframing and mobilizing family to acquire and accept help from others to overcome their challenges. They had positive gains from the parental experience. Immigrant parents had a reasonable level of resilience. Those with a higher level of perceived challenges had a lower level of coping and resilience. Perceived barriers to parental coping included barriers to establishing social networks and utilizing available disability services. Services from competent service providers and the availability of social support networks were factors facilitating immigrant parents' coping. Conclusion: Sensitive communication and culturally appropriate care provided by service providers and healthcare professionals can facilitate service utilization and reduce perceived stigma over children with disability. Impact Findings from the study support that special training provided to healthcare providers about the challenges of immigrant parents raising children with disabilities may enhance awareness of the experience of these parents. Information and instrumental support may help to enhance parental coping, reduce isolation and promote their mental health. Patient or Public Contribution: We thank the immigrant parents and the service providers who have been instrumental in the conception of this study. [ABSTRACT FROM AUTHOR]

Aim: To explore final year nursing students' attitudes towards euthanasia due to unbearable mental suffering by using the adapted and validated Euthanasia Attitude Scale. Design: Cross‐sectional survey. Methods: Explorative, descriptive cross‐sectional study conducted using an e‐mail survey between October 2020 and March 2021 by a sample of final‐year baccalaureate nursing students (n = 273) from eight of the eleven Flemish university colleges. The actual questionnaire contains 21 questions and was developed based on a consensus reached following independent translations. The psychometric properties of the Euthanasia Attitude Scale were assessed, including reliability and validity. Independent‐sample Mann–Whitney U‐test was used to investigate relation between demographic and education‐related data, and domain and total score of the UMS‐EAS‐NL. This study received ethical approval from the Ethical Committee of the University Hospital Brussels, Belgium. Results: McDonald's omega was 0.838 for the total Euthanasia Attitude Scale scores, supporting the validity of the questionnaire. A statistically significant difference in 'Naturalistic beliefs' score was found relating to the year of birth. There are clinically important results between those students who have been involved in euthanasia and those who have not. Conclusions: Most of the final‐year nursing students supported the probability of patients' access to euthanasia due to unbearable mental suffering. To monitor adequate care, it is necessary to prepare nursing students adequately for this complex matter. Impact To date, no large‐scale study has examined nursing students' attitudes towards euthanasia because of unbearable mental suffering. It is expected that nursing students may be confronted with such a euthanasia request during an internship, or later in their professional career, in countries where euthanasia is legal. Students showed a high acceptability towards UMS‐euthanasia. Clinically significant differences were found for students who had ever been involved in euthanasia. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to measure and describe the mental health impact of COVID‐19 on Australian pre‐registration nursing students. Background: The COVID ‐19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID‐19 on Australian pre‐registration nursing students currently. Design: A cross‐sectional study was conducted across 12 Australian universities. Methods: Using an anonymous, online survey students provided demographic data and self‐reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID‐19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale‐Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS‐21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20‐188). All participating universities obtained reciprocal approval. Results: Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID‐19. Close to half of students (n = 255, 49.4%) reported signs of post‐traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID‐19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID‐19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. Conclusion: The COVID‐19 pandemic has considerably impacted pre‐registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. Impact statement This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID‐19. In this study, we found that students with a pre‐existing mental health issue and final‐year students were most affected. The changes to education in Australian universities related to COVID‐19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. Patient or public involvement: The study was designed to explore the impact of COVID‐19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research is to synthesize findings from primary studies (quantitative and qualitative) that investigated the global mental health experiences of single mothers to provide a deeper understanding to better care and respond to the support needs of single mothers. Design: Hayvaert et al.'s mixed methods research synthesis approach. Data Sources: The search process in the following databases, CINAHL, PsycINFO, and Scopus resulted in eight high‐quality studies (5 qualitative and 3 quantitative) published between June 2016 and July 2021. Review Methods: Descriptive statistics and instrument scores were provided in summary form. Themes were analysed using Krippendorff's content analysis. A joint display was provided to reveal a complementary relationship between two different data sets. Results: A total of 348 single mothers participated. Amongst the pooled sample, women identified as: Japanese (n = 174), Israeli (n = 147), Black African (n = 18), African American (n = 9), Native American (n = 5), Burundian‐Australian (n = 8), UK British (n = 12), Asian (n = 3), South Korean (n = 7), Indian (n = 2), Malaysian (n = 44), Hispanic/Latina (n = 1) and Eastern European (n = 3). Four themes were identified: (1) Learning to let go of the past, (2) It takes a whole village: Importance of social support, (3) Seeking a self‐reliant life: Challenges with balancing career & childcare and (4) Finding strength within: Personal growth. Only one intervention utilizing creative group counselling was found to significantly decrease depression (p =.008), anxiety (p =.005), and stress (p =.012) whilst increasing self‐compassion (p =.013). Conclusion: It is important for clinicians who care for single mothers, particularly if they recently immigrated, are multiparous, and an ethnic minority to encourage engagement in peer‐initiated counselling and obtain mental health care as necessary. Impact This study identified and addressed the mental health issues that single mothers face worldwide. This is also the first mixed methods research synthesis to report single mothers' ethnicity in nursing and midwifery literature. Thus, findings from this mixed methods research synthesis can help nurses worldwide build culturally‐concordant programs in their respective community organizations and partners (e.g. community health centres, mother‐child enrichment clubs), inform health policies, and promote safer spaces for many single mothers, particularly for those who will immigrate to the Global North (i.e. UK, US, Canada) and become an ethnic minority. [ABSTRACT FROM AUTHOR]

Aims: To determine the rate and level of postpartum depression (PPD), as well as to examine and compare PPD, social support and maternal self‐efficacy between adolescent and adult mothers at 8 weeks postpartum during the COVID‐19 pandemic. Background: Policy measures to reduce the rapid spread of COVID‐19 have disrupted many aspects of life and decreased social connections, which negatively impacts psychological well‐being of the general population. However, studies focused on the impact of COVID‐19 on mental health and maternal self‐efficacy in postpartum mothers, particularly adolescent mothers, are limited. Design: A comparative cross‐sectional study was carried out following the STROBE guidelines. Methods: An online questionnaire was administered from February to March 2021. Data were collected by the Edinburgh Postnatal Depression Scale (EPDS), the Postpartum Support Questionnaire (PSQ) and the Parenting Sense of Competence (PSOC) at 8 weeks postpartum. One‐way MANOVA was used to analyse the data. Results: Data from 63 adolescent mothers and 63 adult mothers were analysed. There were significant correlations between PPD, social support and maternal self‐efficacy of the COVID‐19 pandemic. Both adolescent and adult mothers had significantly negative impacts from the pandemic on mental health, social support and maternal self‐efficacy. However, the adolescent mothers had higher rates of depressive symptoms (36.5% and 23.8%, respectively) as well as lower PSQ score (121.25 and 130.52, respectively) and PSOC scores (62.54 and 70.94, respectively) compared with adult mothers in the first 8 weeks postpartum during the pandemic. Conclusion: Adolescent mothers had a significantly higher rate of depressive symptoms and significantly lower social support and maternal self‐efficacy scores compared to adult mothers at 8 weeks postpartum during the COVID‐19 pandemic. Impact Midwives or nurses should emphasize the negative mental health impacts during the COVID‐19 situation and routinely screen for depressive symptoms, especially in adolescent mothers, which could help identify the at‐risk mothers for developing PPD. Patient or public contribution: Neither patients nor the public were directly involved in the study. [ABSTRACT FROM AUTHOR]

Aim: To understand coping strategies used by women experiencing gender‐based violence and living in Turkey. Coping is a cognitive and behavioural strategy that individuals develop to manage stress, generally categorized as emotion‐focused or problem‐focused coping. Women exposed to gender‐based violence develop various coping strategies to manage stress and its adverse mental and physical health effects. Design: Qualitative study using the phenomenological approach. Methods: Data were collected in Turkey by using the snowball technique (n = 17) between September 2019 and September 2020. The Clinical Ethnographic Narrative Interview is the source of the qualitative data for this study. Data were coded manually and utilized the RADAR technique. Results: Seventeen women aged 25–40 were included in this analysis. Women stated that they were exposed to more than one type of gender‐based violence according to their lived experiences. Analysis of the nature of coping strategies revealed five main themes. The themes were self‐competence, separation from others/isolation, getting professional help, having faith and social support. Conclusion: Breaking the silence and listening to gender‐based violence experiences from survivors' voices contribute significantly to literature. There was a dearth of research on Turkish women's gender‐based violence survivors; the research intended to address that gap. The participants highlighted that they would like to receive more attention and felt relief in sharing their experiences. Impact The Clinical Ethnographic Narrative Interview is a great tool to explore narratives of gender‐based violence and coping skills of women. The study explored coping strategies of Turkish women's gender‐based violence survivors. The participants indicated their emotion‐focused and problem‐solving coping strategies and shared their stories. This study will enhance efforts to concentrate on gender‐based violence among Turkish women and inspire other researchers, practitioners and policymakers to change and provide more opportunities for the benefit and well‐being of these women. [ABSTRACT FROM AUTHOR]

Aims: The aim of this review was to evaluate the current state of scientific knowledge describing the mental health of Black men who have experienced incarceration. Design: This systematic mixed studies review employed a sequential explanatory design integrating quantitative and qualitative published research. Data sources PubMed, CINAHL, PsycINFO, Social Work and Criminal Justice databases were searched using search terms addressing core constructs of mental health, Black men, incarceration and re‐entry, January 2010 through October 2021. Review methods: Articles identified through a search protocol were screened for inclusion as: peer‐reviewed original research, published in English and relevant to the mental health of formerly incarcerated Black men in the United States. Results: Twenty‐three articles met inclusion criteria. Quantitative findings demonstrated significant associations between incarceration history and poor mental health, including higher levels of psychological distress, increased severity of depressive and PTSD symptoms, and delayed mental health treatment. Discrimination, negative police encounters, solitary confinement and difficulty finding employment were associated with the relationship between incarceration and mental health outcomes. Four themes were identified from the qualitative synthesis: (1) Social Determinants of Mental Health (2) Pushing Through Emotional Despair (3) Challenges to Healthcare Engagement and (4) Gender, Race and Intersections between Social Identities. Impact The United States has the highest rate of incarceration in the world and disproportionately incarcerates Black men. This review contextualizes the relationship between incarceration history and mental health in the lived experiences and perspectives of formerly incarcerated Black men. Findings indicate the need for interventions to support mental health needs and prevent downstream health consequences in this population. Conclusion: Mental health concerns are pervasive in formerly incarcerated Black men; to address key gaps in current scientific understandings future research should focus on how Black men navigate help‐seeking experiences and use mental health services in the context of an incarceration history. [ABSTRACT FROM AUTHOR]

Aims: This review aims to explore the prevalence and incidence rates of mental health conditions in healthcare workers during and after a pandemic outbreak and which factors influence rates. Background: Pandemics place considerable burden on care services, impacting on workers' health and their ability to deliver services. We systematically reviewed the prevalence and incidence of mental health conditions in care workers during pandemics. Design Systematic review and meta‐analysis. Data sources Searches of MEDLINE, Embase, Cochrane Library and PsychINFO for cohort, cross‐sectional and case–control studies were undertaken on the 31 March 2020 (from inception to 31 March 2020). Review methods: Only prevalence or incidence rates for mental health conditions from validated tools were included. Study selection, data extraction and quality assessment were carried out by two reviewers. Meta‐analyses and subgroup analyses were produced for pandemic period (pre‐ and post), age, country income, country, clinical setting for major depression disorder (MDD), anxiety disorder and post‐traumatic stress disorder (PTSD). Results: No studies of incidence were found. Prevalence estimates showed that the most common mental health condition was PTSD (21.7%) followed by anxiety disorder (16.1%), MDD (13.4%) and acute stress disorder (7.4%) (low risk of bias). For symptoms of these conditions there was substantial variation in the prevalence estimates for depression (95% confidence interval [CI]:31.8%; 60.5%), anxiety (95% CI:34.2%; 57.7%) and PTSD symptoms (95% CI,21.4%; 65.4%) (moderate risk of bias). Age, level of exposure and type of care professional were identified as important moderating factors. Conclusion: Mental disorders affect healthcare workers during and after infectious disease pandemics, with higher proportions experiencing symptoms. Impact This review provides prevalence estimates of mental health conditions during and after a pandemic which could be used to inform service staffing impact and formulation of preventative strategies, by identifying clinical populations who may be at high risk of developing mental health symptoms and conditions. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine the potential association of family‐centred care as perceived by parents during a NICU stay with parents' depressive symptoms at discharge and at 4 months corrected for infant age. Design: A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries. Methods: Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants' hospitalizations. They responded to Digi‐FCC daily text messages inquiring about their perception of family‐centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family‐centred care at discharge. Parents' depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age. Results: The mothers' and the fathers' perceptions of family‐centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents' participation in infant care, care‐related decisions and emotional support provided to parents by staff explained the variation in the parents' perceptions of family‐centred care. The factors facilitating the implementation of family‐centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents. Conclusions: Our study shows that family‐centred NICU care associates with parents' depressive symptoms after a NICU stay. Impact: Depression is common in parents of preterm infants. The provision of family‐centred care may protect the mental well‐being of parents of preterm infants. [ABSTRACT FROM AUTHOR]

Aims: To describe the research protocol for an ecological momentary assessment (EMA) designed to examine patterns of suicidal ideation and relevant psychosocial stress indicators in adults at risk for suicide. Design: This observational and longitudinal study will collect data for 28 consecutive days. Methods: A total of 150 adults at risk for suicide will be recruited from a single suicide prevention centre and an outpatient clinic in Korea. Self-report questionnaires will be administrated during weeks 0, 1, 3 and 5. Participants will receive text messages three times a day for 4 weeks prompting them to access an online survey link for daily mood survey including depression, anxiety, stress and suicidal ideation. In addition, for the first 2 weeks, they will wear an actigraphy device designed to collect actigraphic data in terms of sleep patterns and physical activity. Data analyses such as descriptive statistics, independent t-tests, one-way ANOVA, chi-squared statistics and time-series and correlation analyses will be performed using IBM SPSS 26.0 and SAS version 9.3. The study received funding from National Research Foundation of Korea in February 2020. Institutional Review Board approval for our study was obtained in April 2021. Discussions: This study will yield fundamental information about daily patterns of suicide ideation and psychosocial stress indicators to develop preventive interventions for adults at risk for suicide. Impact: Our study will contribute to the development of EMAs and interventions for adults at risk for suicide aimed at providing timely and individualized mental health services in a community setting. Trial Registration: The trial is registered with the Clinical Research Information Service (CRIS). CRIS Registration Number: KCT0006165. [ABSTRACT FROM AUTHOR]

Aims: To explore factors associated with nurses' moral distress during the first COVID-19 surge and their longer-term mental health. Design: Cross-sectional, correlational survey study. Methods: Registered nurses were surveyed in September 2020 about their experiences during the first peak month of COVID-19 using the new, validated, COVID-19 Moral Distress Scale for Nurses. Nurses' mental health was measured by recently experienced symptoms. Analyses included descriptive statistics and regression analysis. Outcome variables were moral distress and mental health. Explanatory variables were frequency of COVID-19 patients, leadership communication and personal protective equipment/cleaning supplies access. The sample comprised 307 nurses (43% response rate) from two academic medical centres. Results: Many respondents had difficulty accessing personal protective equipment. Most nurses reported that hospital leadership communication was transparent, effective and timely. The most distressing situations were the transmission risk to nurses' family members, caring for patients without family members present, and caring for patients dying without family or clergy present. These occurred occasionally with moderate distress. Nurses reported 2.5 days each in the past week of feeling anxiety, withdrawn and having difficulty sleeping. Moral distress decreased with effective communication and access to personal protective equipment. Moral distress was associated with longer-term mental health. Conclusion: Pandemic patient care situations are the greatest sources of nurses' moral distress. Effective leadership communication, fewer COVID-19 patients, and access to protective equipment decrease moral distress, which influences longer-term mental health. Impact: Little was known about the impact of COVID-19 on nurses' moral distress. We found that nurses' moral distress was associated with the volume of care for infected patients, access to personal protective equipment, and communication from leaders. We found that moral distress was associated with longer-term mental health. [ABSTRACT FROM AUTHOR]

Aims: To examine the distributed characteristics and explore the research themes of Doctor of Nursing Practice (DNP) dissertations during the past two decades. Design: A descriptive statistical and visualization bibliometric analysis was conducted. Methods: Doctor of Nursing Practice dissertations submitted between January 2005 and June 2021 were collected from the ProQuest Dissertations and Theses database. A descriptive statistical analysis was conducted to calculate the distribution of the DNP dissertations by granting institution and the published year of publications. The VOSviewer 1.6.13 was used to explore the bibliometric networks and research priorities of the DNP dissertations. Results: A total of 4989 DNP dissertations from 90 universities were included in this study, all from the United States. The number of DNP dissertations showed an upward trend, with steady growth from 2005 to 2014 and rapid growth after 2015. The DNP studies focused on five areas: health care management in clinical nursing, advanced practice in nursing education and health education, public health problems, mental health care for adolescents and nurses and the older people care and long-term care. Conclusion: Parallel to the numerical increase in DNP dissertations is a steady expansion in the range of research topics and scopes, which is aligned with specific specializations of the DNP. Many are interdisciplinary and employ techniques imported from the fields of public health, psychology and social sciences, resulting in nursing educators and practitioners continually broaden their subject perspectives. Impact: Knowing where, when and why DNP research trends developed will help nursing educators to further develop DNP education and optimize DNP programs in the future, such as paying more attention to the nursing practice. Moreover, this study will inspire DNP students and researchers to expand their subject perspectives and broaden the research scope to solve nursing practice problems based on interdisciplinary theories and methods. [ABSTRACT FROM AUTHOR]

Aims: Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. Design: Systematic review and meta‐analysis. Data sources: Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. Review Methods: We included randomized and non‐randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta‐analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. Results: A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role‐plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta‐analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post‐test for simulation compared with active control; and a small and medium effect size on learners' attitudes for simulation compared with inactive control, at immediate post‐test and at three‐month follow‐up respectively. Three quarters of non‐randomized controlled studies and pre/post‐tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post‐tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. Conclusion: These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions. [ABSTRACT FROM AUTHOR]

Aim: To describe promotive and risk factors for children's mental health at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment. Design: A descriptive qualitative interview study. Methods: Data were collected in Finland during autumn 2019 via semi‐structured interviews. Participants (n = 23) comprised public health nurses who worked in child health clinics and school healthcare. Data were analyzed using inductive content analysis. Results: Several promotive and risk factors were identified to have affected children's mental health. Intra‐family factors were the most important in the opinion of public health nurses, and they were most concerned about family related risk factors. In addition, the descriptions of nurses revealed that children are in a socially unequal position in terms of their place of residence. It was also uncovered that there were fewer social and healthcare and leisure services in small municipalities, the distances to services were longer, which was perceived to complicate the use of services, and the fear of stigma was greater. Conclusion: According to public health nurses, factors at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment affect children's mental health and overall well‐being. Consequently, the promotion of children's mental health should be emphasized at every level of the society, considering the whole family. Impact: This study indicated the importance of considering factors that affect children's mental health at all levels of the socioecological environment. The results can be reflected in the relation of the socioecological model of health promotion and used in planning the work of nurses in primary healthcare and other relevant nursing settings to emphasize promotive and preventive work. [ABSTRACT FROM AUTHOR]

Aim. To examine the evidence for incentives and barriers to lifestyle interventions for people with severe mental illness. Background. People with severe mental illnesses, particularly those with schizophrenia, have poorer physical health than the general population with increased mortality and morbidity rates. Social and lifestyle factors are reported to contribute to this health inequality, though antipsychotic therapy poses additional risk to long-term physical health. Many behavioural lifestyle interventions including smoking cessation, exercise programmes and weight-management programmes have been delivered to this population with promising results. Surprisingly little attention has been given to factors that may facilitate or prevent engagement with these interventions in this population. Data sources. Eight electronic databases were searched [1985-March 2009] along with the Cochrane Library and Google Scholar. Electronic 'hand' searches of key journals and explosion of references were undertaken. Review methods. A narrative synthesis of qualitative, quantitative and mixed-methods studies was undertaken. Results. No studies were identified that specifically explored the incentives and barriers to participation in lifestyle intervention for this population. Existing literature report some possible incentives and barriers including: illness symptoms, treatment effects, lack of support and negative staff attitudes as possible barriers; and symptom reduction, peer and staff support, knowledge, personal attributes and participation of staff as possible incentives. Conclusions. Healthcare professionals, in particular nurses, should consider issues that may hinder or encourage individuals in this clinical group to participate in lifestyle interventions if the full benefits are to be achieved. Further research is needed to explore possible incentives and barriers from the service users' own perspective. [ABSTRACT FROM AUTHOR]

Aims: To explore nurses' psychological experiences after inpatient suicide. Design: Qualitative studies were meta‐synthesized. Data sources: Eight databases (PubMed, Web of Science, CINAHL, Embase, Wanfang Data, VIP database, CBM and CNKI) were searched for qualitative studies from each database's inception to 31 August 2020. Review methods: Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta‐synthesized. Results: Eleven studies were included, and five themes were identified: (a) emotional experience, (b) cognitive experience, (c) coping strategies, (d) self‐reflection and (e) impact on self and practise. Conclusion: Nurses reported various negative emotions after inpatient suicide. Hospital administrators should recognize nurses' second victim psychological trauma. Moreover, they must develop theory‐based education, training and psychological support programmes to promote nurses' mental health. Hospital patient safety management is also important to ensure patient safety whilst preventing nurses from becoming second victims. Impact: Understanding the psychological experiences of nurses who have undergone inpatient suicide will inform future research and practise. Nurses require psychological support after experiencing adverse events. Education and training are necessary to help nurses acquire suicide knowledge, understand the role of the second victim, better cope with adverse events and promote self‐growth. Hospitals should strengthen the construction of a safety culture to ensure patient safety. [ABSTRACT FROM AUTHOR]

Aims: Sensory‐based approaches, including sensory room, sensory cart and specific sensory integration programs, feature various sensory stimulations to focus on a particular space or program. This systematic mixed‐methods review describes the impact of sensory‐based approaches in psychiatric care and summarizes the important components of sensory interventions. Design: Systematic mixed‐methods review was based on the guidelines by Pluye and Hong for comprehensively searching, appraising and synthesizing research evidence. Data sources: Data were collected from five databases: CINAHL, Embase, Pubmed, Web of Science and Cochrane before March 9, 2020. Review methods: Qualitative, quantitative, mixed‐methods and original studies published in English on sensory‐based approaches in psychiatric care were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. The data were analysed using thematic analysis. Results: Sixteen studies were chosen for review. Through data integration, four subthemes with positive effects were formed: (1) calming of the patient's mood; (2) calming of the patient's body; (3) improvement of self‐care ability; and (4) improvement of the nurse‐patient relationship. The sensory‐based approach may also lead to negative effects. Conclusions: Several important components play important roles in the sensory‐based approaches: (1) rich, culture‐based, personalized sensory stimulation; (2) a quiet, safe, home‐based physical environment; (3) a good one‐to‐one nurse‐patient relationship; (4) and the cultivation of patient autonomy and self‐management. Sensory‐based approaches in a multicultural environment and home environment will be important topics of psychiatric care in the future. Impact: There is a lack of synthesis of studies on results of sensory‐based approaches in psychiatric care. Four components are important to sensory interventions. It is necessary for mental health service centres and home care for the patients with psychotic disorders to use sensory‐based approaches for reference. [ABSTRACT FROM AUTHOR]