Families who care for schizophrenia suffer stress and lose the ability to treat. Family stress can be mediated by resilience. Objective: This study aimed to develop a family resilience model based on ...family‐centred nursing for persons with schizophrenia. This study used a mixed‐method cross‐sectional approach. The population was a family of caregivers for persons with schizophrenia at Mental Hospital in Surabaya, Indonesia. The respondents were 137 families recruited by simple random sampling. Variables include family factors, risk factors, protective factors, patient factors, family stress, family resilience and family ability to care for persons with schizophrenia. The data were collected using questionnaires and then analysed with partial least squares. The statistical results afforded material for focus group discussions with six families and 10 health workers (psychiatrists, psychologists and nurses) in order to improve the model. The result showed family stress was influenced by family factors (path coefficient = −0.145; t = 2.26), risk factors (path coefficient = 0.753; t = 16.7) and patient factors (path coefficient = 0.159; t = 3.23). Family resilience is influenced by risk factors (path coefficient = 0.316; t = 2.60), protective factors (path coefficient = 0.176; t = 2.22) and family stress (path coefficient = 0.298; t = 2.54). Family resilience affects the family ability to treat persons with schizophrenia (path coefficient = 0.366; t = 5.36). The family resilience model increases family capability by 13.4%. The model helps families through stress management by controlling the burden and stigma so that families are able to survive, rise, growing stronger and be better at caring for persons with schizophrenia.
•There were correlations among mood, sleep, and activity between two weeks and months.•This study measured activity by ascertaining the movement distance based on GPS.•The validity of using ...smartphone-based self-assessed mood and sleep was examined.
The recent popularization of smart technology presents new opportunities for continual, digital-monitoring of patient status. In this project, we used a smartphone app to track the mood, sleep, and activity levels of 159 outpatients with bipolar disorder (BD). The participants were asked to report their daily wake/sleep time and emotional status in the app, while daily activity data were automatically collected via GPS. We performed repeated-measures correlation analysis to examine possible correlations between the readouts. Mood, sleep and activity levels all showed intra-variable correlations with readings on the next day, in the next week, and in the next month. Furthermore, mood and sleep at the reference time were positively correlated with activity in subsequent weeks or months, and activity was positively correlated with mood and sleep in the same time ranges. Thus, our results were in line with previous studies, showing that mood, sleep, and activity levels are interdependent in patients with BD. With the association between mood on future activity level was most significant, and the correlations between each readout and the others were dependent on time frame. Our findings suggest our smartphone app has potential to provide an informative and reliable means for real-time tracking of BD status.
Anti-stigma interventions have become important worldwide in light of the negative consequences that the stigma of mental illness has on the recovery to health of individuals with mental illness as ...well as on general quality of care and public mental health. Thus, psychiatric mental health nursing courses are being targeted with early anti-stigma interventions to improve related awareness and skills among future nurses. This article firstly elaborates on the importance of the stigma issue in psychiatric care and assesses the empirical effectiveness of anti-stigma interventions in psychiatric mental health nursing education. Next, a pedagogical exemplar of integrating a "recovery patients as educators" and anti-stigma intervention into an innovative psychiatric mental health nursing course is demonstrated. Community psychiatric patients, who traditionally receive passive care from healthcare providers, were invited to attend psychiatric mental health courses with the goal of becoming educators in their communi
•Using smartphones and the Internet to track bipolar disorder patient status has become a common method.•The proposed app's development emphasizes user experience, ensuring its ...usability.•Additionally, the study presents a series of research procedures devised to authenticate the app-collected data's reliability and precision for clinical analysis.
Daily life tracking has proven to be of great help in the assessment of patients with bipolar disorder. Although there are many smartphone apps for tracking bipolar disorder, most of them lack academic verification, privacy policy and long-term maintenance.
Our developed app, MoodSensing, aims to collect users' digital phenotyping for assessment of bipolar disorder. The data collection was approved by the Institutional Review Board. This study collaborated with professional clinicians to ensure that the app meets both clinical needs and user experience requirements. Based on the collected digital phenotyping, deep learning techniques were applied to forecast participants' weekly HAM-D and YMRS scale scores.
In experiments, the data collected by our app can effectively predict the scale scores, reaching the mean absolute error of 0.84 and 0.22 on the scales. The statistical data also demonstrate the increase in user engagement.
Our analysis reveals that the developed MoodSensing app can not only provide a good user experience, but also the recorded data have certain discriminability for clinical assessment. Our app also provides relevant policies to protect user privacy, and has been launched in the Apple Store and Google Play Store.
Family interventions have been emphasized in the treatment of bipolar disorder (BPD) due to the bidirectional and entangled relationships between patients and the family system, and have benefits for ...patients’ symptoms and health; however, the effects of family interventions on family function and caregivers’ health‐related outcomes have not been well investigated. This randomized, controlled trial with 47 hospitalized patients with BPD/family caregiver dyads at a medical centre in northern Taiwan compared the effects of a brief family‐centred care (BFCC) programme with treatment as usual (TAU). All of the family caregivers in two groups were invited to attend a routine 60‐min family discussion group about violence and suicide prevention. The TAU group without specific family interview for patient and family caregiver dyad. In the BFCC group, four 90‐min BFCC programme sessions were additionally provided twice a week for each hospitalized family dyad. We hypothesized that, first, family caregivers in the BFCC group could increase their family function, and second, improve perceived health status and reduce caregiver's burdens compared to the TAU. The results showed that family caregivers in the BFCC group significant interaction effects in overall family function (P = 0.03) and subscale conflict (P = 0.04), communication (P = 0.01), and problem‐solving (P = 0.04), but there were no significant interaction effects on the caregivers’ perceived health status and caregivers’ burdens. Our findings support both the feasibility of using the BFCC programme for inpatients and its specific benefits for family function. An intensive family intervention during hospitalization has been suggested in psychiatric practice to support patients with BPD and family caregivers.
This cross-sectional study was conducted to examine 256 Muslim nurses' perception of spirituality and spiritual care in Indonesia. The Spirituality and Spiritual Care Rating Scale (SSCRS) was ...translated and culturally adapted. Moderately high degrees in five domains and total SSCRS were found. Specialty, education level, clinical seniority, having spiritual training, and previous spiritual caring experience could impact on the SSCRS. Most nurses have cared for patients with spiritual needs, but denied having any formal training in providing spiritual care. Providing adequate curriculum and on-job training to equip nurses' knowledge and competence of spiritual care is urgent in Muslim healthcare environment.
Aims and objectives
This study investigated nurse practitioners’ clinical decision‐making abilities and the factors that affect these abilities.
Background
Nurse practitioners play an important role ...in clinical care decision‐making; however, studies exploring the factors that affect their decision‐making abilities are lacking.
Design
A cross‐sectional descriptive survey was employed.
Methods
A purposive sample of 197 nurse practitioners was recruited from a medical centre in central Taiwan. Structured questionnaires consisting of the Knowledge Readiness Scale, the Critical Thinking Disposition Inventory and the Clinical Decision‐Making Model Inventory were used to collect data.
Results
The intuitive‐analytical type was the most commonly used decision‐making model, and the intuitive type was the least frequently used model. The decision‐making model used was significantly related to the nurse practitioners’ work unit. Significant differences were noted between the nurse practitioners’ clinical decision‐making models and their critical thinking dispositions (openness and empathy). The nurse practitioners’ years of work experience, work unit, professional knowledge and critical thinking disposition (openness and empathy as well as holistic and reflective dispositions) predicted the nurse practitioners’ analytical decision‐making scores. Age, years of nurse practitioner work experience, work unit and critical thinking disposition (holistic and reflective) predicted the nurse practitioners’ intuitive decision‐making scores.
Conclusions
This study contributes to the topic of clinical decision‐making by describing various types of nurse practitioner decision‐making. The factors associated with analytic and intuitive decision‐making scores were identified. These findings might be beneficial when planning continuing education programmes to enhance the clinical decision‐making abilities of nurse practitioners.
Relevance to clinical practice
The study results showed that nurse practitioners demonstrated various clinical decision‐making types across different work units. Consideration of nurse practitioners’ knowledge readiness and their specific needs while planning on‐duty education programmes is necessary.
Introduction: Although Muslims constitute nearly one fourth of the global population, many non-Muslims are not familiar with Islam. To address this unique need from such a specific cultural context, ...the present study aimed to examine the spiritual needs and influencing factors of Indonesian Muslims with cancer. Method: A cross-sectional research design with 122 cancer patients was conducted by using the Bahasa-version Spiritual Needs Questionnaire. Results: The degree of spiritual needs was generally high. Religious needs were the strongest aspect, and “praying five times a day” was the highest scoring item. Gender (p = .04), age (p = .01), and duration of being diagnosed with cancer (p = .01) were associated with spiritual needs. Female gender (p = .005) and older age (p < .001) were predictors of spiritual needs. Discussion: As expected to provide cultural-congruent spiritual interventions, nurses could meet Muslim patients’ need to pray five times a day during hospitalization, thus help them manage and endure the illness.
Clinical rating scales can be used to assess the severity of bipolar disorder; however, their use involves clinician-patient interactions, which is labor-intensive. Therefore, this study proposes a ...digital-phenotyping-based system that provides clinical ratings of bipolar disorder severity using global positioning system, self-scale, daily mood, user emotion, sleep time, and multimedia data; these ratings are given on Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS). A K-nearest-neighbor-based imputation method was used to handle missing data. In this method, missing data points are filled in with the multiple correlations between different features. Furthermore, the Least Absolute Shrinkage and Selection Operator (Lasso)-regression-based multilayer perceptron (Lasso-MLP) method was adopted to predict the total and factor scores on the HAM-D and YMRS. Five-fold cross-validation were used in evaluation experiments. When the designed data imputation method was used with Lasso-MLP, the mean square errors of the total score and average factor score on HAM-D (the YMRS) were 0.56 (0.38) and 1.88 (0.98), respectively, which were smaller than the corresponding values obtained through Lasso regression (by 0.12 and 0.05, respectively, for HAM-D and by 0.12 and 0.10, respectively, for the YMRS). The experimental results also indicated that the models trained with the imputed data outperformed those trained without imputed data. Thus, the developed approaches can eliminate the missing data problem and provide accurate clinical ratings.
In the context of familial paternalism in Taiwan, nonreading older adult women (NOAWs) may passively disengage from treatment and submit to the decisions of their families. The purposes of this case ...study were to examine the ethical conflicts regarding the autonomy of hospitalized NOAWs receiving percutaneous coronary intervention in a cultural environment of familial paternalism and to propose a theoretical framework based on a literature review to resolve the ethical challenges specific to this cultural context. The proposed framework “Nursing advocacy model for engaging NOAWs with their medical treatment” was established on the basis of relational ethics, nursing advocacy, and shared decision making. Our argument does not question traditional Chinese cultural values. Instead, we advocate for NOAWs to engage with their treatment, express their preferences, and communicate with their families in a decision-making process that incorporates mutual respect and understanding within the context of Chinese culture.
