1,720,977 research outputs found
Transitioning from Child/Adolescent to Adult Mental Health Services
No full textThe purpose of this qualitative study was to explore the experiences of young adults transitioning from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) from the perspectives of patients. Using convenience sampling, six participants were recruited for individual semi-structured interviews. Using conventional content analysis, I identified five categories reflective of the participants' experiences: 1. 'Expectations', 2. 'Transition is a Gradual Process and not an Abrupt Change', 3. 'Factors Influencing Transition', 4. Living the Transition' and 5. 'Improving the Transition'. These categories included subcategories, when appropriate, to highlight variation within the main experiences. The findings provide insight into the experiences of young adults who are - or have lived - the transition from CAMHS to AMHS from their perspectives. The participants' stories are useful to understand the physical and emotional challenges associated with shifting to adult care, and their recommendations can help to inform healthy transitions in this context
Post-Secondary Students with Symptoms of Psychosis: A Mixed-Methods Systematic Review
No full textThe purpose of this thesis was to synthesize evidence on symptoms of psychosis in post-secondary students, including participant characteristics, prevalence, risk factors, interventions, and reported experiences. The design was a mixed-methods systematic review, modeled on the Joanna Briggs Institute and PRISMA guidelines, with all standard systematic review procedures followed. A search in nine databases yielded 26 (published between 2006 and 2018) articles for inclusion. Data were analyzed according to objectives and reported using synthesis tables and narrative summaries. Average age of participants was 21 years and most identified as female and Caucasian. Prevalence of psychosis across the included studies was inconclusive. Risk factors associated with symptoms of psychosis included substance use, depression, and younger age. There were five interventions with mixed results and three studies about experiences. While five promising interventions exist, inadequate testing and replication limits confidence in their effectiveness. There is a notable deficit in qualitative evidence exploring the experiences of students with symptoms of psychosis
Patient and Clinician Perspectives on Patient Portal Use in the Mental Health Context
No full textPatient portals facilitate patients' access to their electronic health care records, and may also include features such as patient-clinician messaging, prescription renewal, and educational resources. There is evidence that portals support patient empowerment, therapeutic communication, adherence to treatment, and satisfaction with care. Nonetheless, patient portals are underutilized in mental health settings, with policies in some health care organizations restricting all access to mental health records through patient portals. A qualitative evidence synthesis was conducted to explore the perspectives of clinicians and patients on portal use in the mental health care context represented in the current literature. A systematic search of relevant databases, followed by citation and article screening, yielded 24 qualitative and mixed-methods studies for inclusion, and a thematic synthesis was performed. The synthesis yielded five themes: impacts to the efficiency of mental health care delivery; effects on therapeutic relationships between clinicians and patients; changes to the patient-clinician power balance; the suitability of patient portals for patients with mental illness; and the complexities of information management in mental health care. Ultimately, both clinicians and patients acknowledged numerous potential benefits of patient portals, but there were also concerns about their use specific to the mental health context. These concerns were voiced primarily by clinicians, and originated in part from concern for patient safety, but also from stigmatizing attitudes and the perceived threats of portals to clinicians' workloads and control over the record. This systematic review of qualitative studies highlights opportunities for organizations to support their clinicians through the implementation of recovery-oriented initiatives like patient portals, and to support patients with mental illness by ending discriminatory policies limiting access to their records
The experience of persons with BPD who frequently visit the emergency department with mental health-related complaints
No full textUnderstanding Refugee Women’s Contraceptive Health Needs: A Scoping Review
No full textBackground: Canada has accepted over 40,000 refugees in the past five years. Approximately half of these are women of reproductive age. Following forced displacement, refugee women face several health inequities that affect their use of health services. Refugee women underutilize contraceptive care and have unmet contraceptive needs, and yet many engage in unprotected sexual activity with no desire to conceive. With the humanitarian crisis causing record-breaking shifts in migration, it is imperative that nurses understand the needs of refugee women related to their contraception. Objective and methods: To systematically identify the global literature on refugee women’s use of contraception within the reproductive age group. A scoping review study design using Arksey and O’Malley’s methodology was used. The systematic search of PubMed, Embase, CINAHL,Global Health, Nursing and Allied Health, Scopus, PsychInfo, and Gender Watch databases was designed with a health sciences librarian. All standard synthesis procedures were followed. The Integrated Framework for Health (IFH) guided data synthesis and I followed the PRISMA-ScR guideline in the conduct and reporting of the study. Results: Social characteristics, risk and protective factors, psychosocial resources, and health status factors that influence refugee women’s use of contraception, as well as key knowledge gaps. Conclusion: While each refugee will experience their forced displacement differently, there are patterns relevant to their contraception use that can inform clinical practice, policy, education, and future research
Exploring Women's Experiences of Infertility, Reproductive Loss, and Grief
No full textThe purpose of this study is to understand the experiences of women who suffered treatment failure or spontaneous abortion after funded in vitro fertilization. A multi-modal strategy was employed to recruit eligible participants for in-depth interviews. Eight categories emerged from the inductive process of conventional content analysis, focusing on the pursuit of in vitro fertilization, feelings of uncertainty, factory-like characteristics of clinics, insensitive fertility-based comments, and the emotional rollercoaster of undergoing fertility treatments. Additional findings included relationship changes, the taxing nature of treatments, and planning post-reproductive loss. The participants also provided recommendations for improving the program, like streamlining communication, expanding fertility services, and offering mental health care in conjunction with funded in vitro fertilization treatments. The findings suggest that women who suffer treatment failure or spontaneous abortion in the wake of funded in vitro fertilization face an array of emotional responses, but primarily experience a sense of grief
Category Status Conversations in the Psychiatric Context
No full textBackground:
Patients with mental illness often experience stigma and marginalization, which affects the quality of their healthcare. In most settings, end of life decisions, including goals of care, must be discussed with all patients upon hospital admission. This includes determining cardiopulmonary resuscitation preferences, in the event of a medical emergency. Despite this requirement, category status conversations do not routinely occur in psychiatry. It is common for psychiatric inpatients, including those at high risk for cardiac or respiratory arrest, to be admitted, cared for, and discharged without their category status known or documented. By default, patients become a ‘full code status’, which mandates life-sustaining interventions, including CPR. Unwanted interventions are often unsuccessful and inappropriate. They might also cause harm through increased pain and suffering or have no medical benefit.
Aim:
To explore how and why category status conversations occur, or do not occur, for patients admitted to psychiatry. Methods:
This was a descriptive qualitative study, with data collected through two semi-structured focus groups. Nine nurses working in psychiatry, representing two campuses of a larger tertiary care academic hospital in Ottawa, Ontario participated. Elo and Kyngäs’s approach to inductive content analysis was used to analyze the verbatim transcripts of the focus group discussions.
Findings:
Findings reveal the shared experiences of nurses initiating and engaging in category status conversations with patients admitted to psychiatry. Four overarching categories were identified: ‘The Psychiatric Culture’, ‘Being a Psychiatric Patient’, ‘Physical Health Status’, and ‘Suggestions and Recommendations’. Participants spoke about important considerations for the advancement of knowledge regarding category status conversations in psychiatry, including the nurse’s role in category status determination, the challenges of implementing a ‘one-size fits all’ approach to category status policies, and the ways in which HCPs perceptions of patients who are receiving care for depression or suicidal ideation influence these conversations in psychiatry.
Conclusion:
Nurses working in psychiatry care for patients with complex medical and psychiatric comorbidities, who are also sometimes older and frail. Category status determination for these patients is complicated and often the documented status is based on clinician presumption rather than consultation with the patient. Although the importance of completing category status conversations with patients admitted to psychiatry is known, they seldomly occur, and there is ambiguity about the nursing role within the psychiatric context. Efforts are needed to improve nurses’ contributions to category status determination for patients admitted to psychiatry, to ensure that patients’ preferences are known and upheld. Further, there are illness-related factors that complicate typical processes used to discuss and identify patient preferences, such as suicidal ideation and minimal family support. These considerations must be accounted for in hospital policy if meaningful practice change is expected
- …
