karen wright
University of Central Lancashire, School of Health, Faculty Member
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Research Interests: Communication, Mental Health, Medicine, England, Therapeutic drug monitoring, and 14 moreHumans, Time Management, Mental Disorders, Workload, Questionnaires, Drug Therapy, Psychotropic Drugs, B, Psychiatric Mental Health Nursing, Health Facility Environment, Acute Disease, attitude to health, Psychology and Cognitive Sciences, and Medical and Health Sciences
Forensic mental health nurses who work with patients who have severe and enduring mental health needs have been identified as at risk of suffering from occupational stress, and even developing burnout syndrome. Therefore, this article... more
Forensic mental health nurses who work with patients who have severe and enduring mental health needs have been identified as at risk of suffering from occupational stress, and even developing burnout syndrome. Therefore, this article reviews the available literature on stress and burnout in inpatient forensic mental health nursing to identify the stressors and to highlight recommendations. From the review, the main stressors placed on forensic nurses are identified as interprofessional conflicts, workload, and lack of involvement in decision-making. Recommendations to reduce stress and burnout for nurses within this specialty are highlighted. These are identified as follows: staff should have easy access to support systems including clinical supervision; managers should foster an open and honest culture to enable staff members to express their feelings openly or in confidence and learn how to deal with their frustrations; and staff should be encouraged to rotate wards to increase p...
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Research Interests: Adolescent, Medicine, Empathy, Humans, Forensic Nursing, and 12 moreFemale, Male, Psychiatric Nursing, Nurses, Great Britain, Questionnaires, Institutionalization, Analysis of Variance, Adolescent Behavior, Psychiatric Mental Health Nursing, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Aim: To explore the lived experience of the relationship between women with anorexia and their care workers in the context of a specialist eating disorder unit. Background The establishment of a positive therapeutic relationship (TR) has... more
Aim: To explore the lived experience of the relationship between women with anorexia and their care workers in the context of a specialist eating disorder unit. Background The establishment of a positive therapeutic relationship (TR) has been widely acknowledged internationally as an intrinsic part of therapy and caring services; which is healing and restorative in its own right. A TR is crucial when working with patients who are difficult to engage and have high 'drop-out' rates such as those within eating disorder services who are considered to be ‘high risk’, ‘difficult’, ‘defiant’, ‘reluctant to engage in treatment’ and ‘frustrating’ (Fairburn and Harrison, 2003; Pereira et al, 2006). To date there has not been any qualitative exploration of the therapeutic relationship involving women and their care workers. Method/ Methodology This interpretive phenomenological study focuses on women with anorexia and their care workers in both day care and in-patient specialist eating...
The therapeutic relationship is pivotal to mental health nursing, but very little is known about how it is experienced in adult eating disorder services. This paper reports on a research project that sought to discover how the therapeutic... more
The therapeutic relationship is pivotal to mental health nursing, but very little is known about how it is experienced in adult eating disorder services. This paper reports on a research project that sought to discover how the therapeutic relationship is experienced between care workers and women with anorexia nervosa in an adult eating disorder service. Both care workers and women spoke of a relationship that had similarities to the mother-daughter relationship, that it felt therapeutic and that it was in keeping with a professional and compassionate nursing approach. These findings provide new insight. Maternalism is seen as a positive, nurturing and transient relationship that ensures the safety of the person and promotes recovery and transition to eventual independence. This paper reports on a UK interpretative phenomenological research study that aimed to explore the lived experience of the relationship between women with anorexia and their care workers in the context of a spec...
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This paper provides a brief overview of research conducted within a high security hospital to ascertain staff and patient views on how aggression and violence are managed and their subsequent impact on all parties. Both the National... more
This paper provides a brief overview of research conducted within a high security hospital to ascertain staff and patient views on how aggression and violence are managed and their subsequent impact on all parties. Both the National Institute for Mental Health in England (NIMHE, 2004) and the National Institute of Clinical Excellence (NICE, 2005) have emphasized the need to take account of contextual factors when considering the cause and management of aggression. While patient variables (internal) are important within psychiatry, the environment or setting (including culture), relational issues (including gender) and staff attitude are equally important (Jansen et al. 2006). Duxbury & Whittington (2005) found that poor communication contributed to the development of patient aggression, whereby restrictions and environmental factors are fundamental to relational issues. There is currently very little research conducted in high secure services (HSS) that focuses on the management of violence and aggression (MVA) in this context. Uppal & McMurran (2009) report on the frequency and nature of incidents of violence, selfharm and security and Ireland (2006) consider bullying within this context. However, these studies do not focus specifically on the attitudes of staff and patients to violence and aggression. McKeown & Stowell-Smith (2006) speak about the construction of ‘difference’ between staff and patients, who exist in conditions of high security; they suggest that we separate ourselves from those with psychopathic personalities to cope with the work, but acknowledge that this creates its own difficulties within the establishment of the therapeutic relationship. More recently, Canadian authors Jacob et al. (2009) stated that ‘Forensic psychiatric nurses work with individuals who may evoke feelings of empathy as well as feelings of disgust, repulsion, and fear.’ (p. 153). They attribute these emotions to the fear of caring for individuals who are viewed as ‘monsters’ (Jacob et al. 2009). This view resonates with that of McKeown & Stowell-Smith (2006), who suggest that in the face of abjection, staff create a context that constructs a sense of difference and ‘otherness’ between themselves and the patients. They suggest that developing greater understanding, and thus a better attitude towards the client group, would benefit forensic mental health nurses. This in turn, would enable them to engage in a reflective process regarding their professional practice, and, as a result, improve the provision of nursing care. Such commentary is valuable, but is based upon observation and experience rather than research.
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Research Interests: Psychology, Nursing, Communication, Mental Health, Organizational Culture, and 14 moreFocus Groups, Forensic psychiatry, Medicine, United Kingdom, Prisons, Humans, Female, Male, Social Environment, Mental health services, Public health systems and services research, Inpatients, Organizational case studies, and interprofessional relations
ACCESSIBLE SUMMARY: • A key role of nursing staff in high secure hospitals is responding to patients' aggressive behaviour. • Attitudes of staff in high secure hospitals may influence how they respond to patient aggression. • ... more
ACCESSIBLE SUMMARY: • A key role of nursing staff in high secure hospitals is responding to patients' aggressive behaviour. • Attitudes of staff in high secure hospitals may influence how they respond to patient aggression. • Patients will have their own attitudes towards aggression and how it should be managed. • In our study, the views of staff and patients regarding aggression were overall similar, with both groups espousing controlling means of aggression management (medication, restraint, seclusion) in addition to interpersonal strategies. ABSTRACT: Responding to aggressive behaviour is a key activity for nurses and other care staff in high secure hospitals. The attitudes and beliefs of staff regarding patient aggression will influence the management strategies they adopt. Patients will also hold attitudes regarding the causes of and best ways to respond to aggressive behaviour. This study measured the attitudes towards aggression of staff (n= 109) and patients (n= 27)...
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Violent and aggressive behaviour towards nurses is common, especially in mental health settings. This article explores the value and safety of existing approaches to dealing with violence and aggression, including the use of physical... more
Violent and aggressive behaviour towards nurses is common, especially in mental health settings. This article explores the value and safety of existing approaches to dealing with violence and aggression, including the use of physical restraint and medication. It highlights the need for greater preventive and participatory measures, and the use of less reactive strategies, such as advance directives.
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The therapeutic relationship is of particular importance when working with patients with antisocial personality disorder, but despite this, there is a paucity of literature exploring student nurses' perceptions of developing a... more
The therapeutic relationship is of particular importance when working with patients with antisocial personality disorder, but despite this, there is a paucity of literature exploring student nurses' perceptions of developing a therapeutic relationship with such patients. Hence, this qualitative study explored the perceptions of second-year mental health nursing students of developing a therapeutic relationship with this patient group. Student nurses from a University in the Northwest of England participated in two focus groups, to compare the perceptions of a group of student nurses who had experience in secure settings (forensic hospital) with those who had not. Four key themes emerged: diagnosis, safety, engagement, and finally environmental influences. Both groups commented on looking beyond the diagnosis and seeing the person. The student nurses cited other staff in their clinical placement areas as hugely influential in terms of the development of their perceptions of patie...
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This study utilized a social constructivist model and reports upon interviews conducted with five female patients in a medium secure service. Their perception of self-harm is considered. Six themes emerged from the data, 'the... more
This study utilized a social constructivist model and reports upon interviews conducted with five female patients in a medium secure service. Their perception of self-harm is considered. Six themes emerged from the data, 'the traumatized individual', 'interrupted maturation process', 'the hidden experience', 'crossing the line', 'individual and systemic repercussions', 'nascent potential protection'. In addition to the six themes that emerged, we concluded that, although individual perceptions of self-harm varied, commonalities existed across accounts and that individual formulation may assist both patients and staff to gain a personalized understanding, thus, enabling less harmful ways of coping to be established.