Psychiatric Mental Health Nursing

Nurses have been employed as behavioural psychotherapists for over 25 years. The first training in this field was established at The Maudsley Hospital ( Marks et al. 1977 ). Since then there have been a number of courses producing many specialist nurse behavioural psychotherapists (NBTs) ( Duggan et al. 1993 ). Nurse behavioural therapy is taken to mean nurses working as behavioural psychotherapists. This title does not mean they are practising a separate form of therapy from other professionals such as psychologists. In Australia there is no such training, with nurse behavioural psychotherapists working here having trained first in UK. Initially NBTs were trained to treat people with anxiety disorders. Over the past 25 years this emphasis has remained, but many NBTs have gone on to provide help to people with other problems. This paper will demonstrate the practical application of behavioural psychotherapy with problem gamblers, and how specialist trained nurses can provide such treatment. The paper will look briefly at nurse behavioural psychotherapy from its initial inception to its current status in Australia. The outcomes of the treatment programme carried out at Flinders Medical Centre for Problem Gamblers will be discussed with a view to nurses carrying out therapy. Finally, the future of nurse behavioural psychotherapy in Australia and how nurses can apply such skills across a wide range of problems, including gambling, will be reviewed.Aspects of this paper were first presented to the 7th NAGS conference, Adelaide 1996.

Treatment of Gilles de la Tourette syndrome using behavioural psychotherapy: a single case example.This paper describes the clinical condition of Gilles de la Tourette syndrome (TS) and outlines some of the causes for the condition and its possible treatments. It describes a single case demonstrating the effectiveness of one type of treatment, namely habit reversal. Finally the implications of the condition's classification as a psychiatric disorder are discussed as is the possibility that other health care professionals may be able to help in the treatment of such cases.

The authors conducted an all-Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used. These included the General Health Questionnaire (GHQ-12), Maslach Burnout Inventory (MBI), Rosenberg Self-Esteem Scale (SES), Community Psychiatric Nursing (CPN) Stress Questionnaire, and PsychNurse Methods of Coping Questionnaire. The findings from the Rosenberg SES are reported here. Community mental health nurses in Wales scored as having average self-esteem. When the data were divided into high and low self-esteem, a large group of CMHNs (40%) were found to have low self-esteem. Factors that are associated with low and high self-esteem were identified. Alcohol consumption and being on lower nursing grades (D, E, F) were associated with low self-esteem, whilst amount of experience working as a CMHN was associated with high self-esteem.

Social policy greatly influences the working environment of mental health nurses but in practice can be difficult to translate. Empowerment of service users is one area that is constantly significant in policy, locally and nationally, yet quite difficult to define in practice. This ethnomethodological study explored the practice of 10 mental health nurses working in an acute admissions unit. Through semi-structured interviews, the nurses were asked to discuss the taken-for-granted methods of empowerment with individual service users, their families and with work colleagues. The results were thematically analysed and compared with international findings, which reflected an awareness among mental health nurses of empowering practice in four areas. These were: Working with mental illness, Making connections, Responsibility and Teamworking.

There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within the UK. Seventeen papers were identified in the literature, seven of which looked at stress and burnout for all members of community mental health teams (CMHTs) and the remaining 10 papers focused on CMHNs. The evidence indicates that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout as a result of increasing workloads, increasing administration and lack of resources. For CMHNs specific stressors were identified. These included increases in workload and administration, time management, inappropriate referrals, safety issues, role conflict, role ambiguity, lack of supervision, not having enough time for personal study and NHS reforms, general working conditions and lack of funding and resources. Areas for future research are described and the current study of Welsh CMHNs is announced. This review has been completed against a background of further significant changes in the health service. In the mental health field, specific new initiatives will have a significant impact on the practice of community mental health nursing. A new National Framework for Mental Health, along with a review of the Mental Health Act (1983), will undoubtedly help to shape the future practice of mental health nursing.

Assessment is the foundation of mental health nursing practice, but little is known of how it is undertaken. This paper explores how mental health nurses describe the content of a comprehensive mental health nursing assessment. Eighteen nurses who worked in inpatient and community settings either as clinicians or managers, ranging from new graduates to nurses with greater than 20 years of experience, were interviewed and asked to describe the content of a comprehensive mental health nursing assessment. Transcribed interviews were analysed using a grounded theory methodology. The primary theme to emerge was one of variability. Most respondents hesitated and then identified different content areas that needed to be assessed as part of a comprehensive mental health nursing assessment. If the areas that are being assessed vary between nurses, then logically the types of interventions being offered will also vary. These results have implications for the education of nurses, their clinical practice, ongoing supervision and research into contemporary mental health nursing practice.

This randomized-controlled trial investigated the effect of physical exercise programme (PEP) on happiness among older adults in Nowshahr, Iran. Results of this study on 120 male and female volunteers showed that an 8-week group physical exercise programme was significantly effective in older adults' happiness. Findings showed that physical exercise programme is so beneficial for increasing older adults' happiness. Physical activity is associated with well-being and happiness. The purpose of this study was to determine the effects of an 8-week long physical exercise programme (PEP) on happiness among older adults in Nowshahr, Iran. This was a randomized control trial study. The participants consisted of a group of 120 male and female volunteers (mean ± SD age: 71 ± 5.86 years) in a convenience sampling among older adults in public parks in Nowshahr, Iran. We randomly allocated them into experimental (n = 60) and control (n = 60) groups. A validated instrument was used to mea...