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Experiences of Caregivers During Inpatient Psychiatric Hospitalization
No full textIn the United States, 8.4 million people provide informal caregiving to people living with mental illness. Many of these caregivers are not included in the treatment process and decision making during inpatient hospitalization despite calls for more caregiver involvement. This mixed-methods study examined caregiver satisfaction and perceptions of care at a Pacific Northwest inpatient psychiatric unit to determine ways to improve caregiver engagement. A convenience sample of caregivers (N = 19) participated in a survey using modified questions from the Ontario Perception of Care Tool for Mental Health and Addictions for Caregivers. Most participants identified as the spouse, partner, or significant other (37%) and reported that their loved one had been diagnosed with bipolar disorder (58%). Participants responded to six Likert-scale questions about satisfaction and two open-ended questions about perceptions of care. Most caregivers felt that they were valued members of the care team, staff responded to their needs and concerns, and they were provided with information about their loved one. However, some participants felt that staff did not encourage hope, failed to keep them updated, and excluded them from treatment decisions. Content analysis of open-ended responses revealed four themes: appreciating responsiveness from staff, feeling positive about the relationship with staff, struggling to communicate, and difficulties with admission and discharge. Overall, caregivers reported mixed satisfaction with inpatient psychiatric care. Findings suggest that inpatient units should focus on improving communication with caregivers. Special consideration should be made for spousal caregivers and those supporting individuals with bipolar disorder
Perceptions, Knowledge, and Barriers to Accessing Mental Health Services
No full textBackground: While improving the mental health of college students is a worldwide goal of the World Health Organization, programs to address student needs in the United States are under-resourced, complex to access, and frequently confusing. In 2024, the National College Health Assessment found that 21% of college students scored high in severe psychological distress, 50% were positive for loneliness, 11% reported self-injury over the previous 12 months, and 28% scored positive on suicidal screening. Nursing students have increased levels of depression, anxiety, sleep disturbances, stress-related illness, and suicide. Aim: The first aim of this project was to identify perceptions, knowledge, and barriers to accessing mental health services among undergraduate nursing students. The second aim was to investigate demographic differences within the sample, to identify different needs or increased barriers. Methods: An anonymous survey, Perceptions, Knowledge, and Barriers to Student Mental Health Services, was created using Qualtrics to collect undergraduate nursing students\u27 demographic and mental health data. A Likert scale was used to obtain the degree of agreement with statements regarding perceptions, knowledge and barriers (PKB) to mental health services. Results: Students reported that time, finances, and uncertainty that others in their social group would seek mental health services, would be barriers to seeking mental health care. Implications for Practice: The barriers of time and finances may be addressed by expanding the urgent care hours at the student health services and ensuring that students know of their limited cost. Education and guidance on the barriers that most commonly limit a student’s desire to seek mental health care and incorporation of assignments for practicing self-care activities as a part of developing sustainable nursing practice may address this critical concern
Evaluating Vaginal Breech Birth Outcomes
No full textIntroduction: The publication of the Term Breech Trial (TBT) in 2000 concluded that cesarean delivery (CS) is the safest route for term breech pregnancies; as a result, current hospital standards in the United States (U.S.) require breech presentation fetuses to be delivered via CS and medical and nursing institutions have discontinued vaginal breech birth training. There is currently no large clinical outcome data available to compare clinical outcome data of providers trained in VBB. Identifying and publicizing VBB maternal and neonatal outcomes when attended by a provider who has completed VBB training can help to make VBB more accessible and safer.
Methods: This project utilized an online database called Kobo toolkit for data collection. A primary data analysis was conducted of 127 surveys submitted by self-selected participants in an international hybrid VBB training program from May 2021 to January 2025. This analysis serves as a summative quantitative data analysis of physiologic VBB clinical data outcomes.
Results: Across 127 survey responses, there were reports of 5 fetal mortalities and 0 maternal mortalities. 1 mother was reported to have experienced severe pre-eclampsia, no other potentially life-threating conditions were reported. Sixteen moderate to severe neonatal morbidities were reported. Of note, 57% of cases were found in a frank breech presentation, 18% of cases in a complete breech presentation without dropped feet, 6% of cases in a complete with two dropped feet presentation, 4% of cases in a complete presentation with 1 dropped foot, 4% of cases in a incomplete presentation with 1 dropped foot, 6% of cases in an incomplete presentation without any dropped feet, and 5% of cases in another breech presentation. Ninety six percent of surveys reported freedom of movement encouraged during labor, with an average time from rump to birth of 3.959 minutes. Labor was induced in 5.5% of cases and augmented in 12.6% of cases. Hands-on maneuvers to assist in the birth were reportedly used in 47% of surveys, the most common being shoulder press in 73.3% of these cases.
Discussion: This data collection provides context for findings related to VBB clinical outcomes. This will serve as the first study to look at clinical outcome data of a vaginal breech training program. Increasing the knowledge of the current outcome statistics for VBB when attended by a skilled and trained VBB provider will help support birth autonomy and guide future clinical practice decision making
