PURPOSE: The purpose of this study was to identify the moderating effect of social support on the relationship between violence experiences and violence responses of psychiatric nurses. METHODS: In this descriptive study, 211 psychiatric nurses were recruited from twelve psychiatric hospitals. A structured self-report questionnaire was used to measure the study variables. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and a series of multiple linear regression analyses based on Baron and Kenny's method with the SPSS 24.0 program. RESULTS: Violence responses positively correlated with violence experiences (r=.15, p=.031), but negatively correlated with social support (r=−.25, p<.001). Social support was a significant variable on violence responses (β=−.26, p<.001). Social support did not moderate effect (β=−.06, p=.377). However family support was significant in controlling emotional responses to psychiatric nurses' experience of verbal violence (β=−.15, p=.027). Friends support was significant in controlling social responses to psychiatric nurses experienced verbal violence (β=−.14, p=.041). CONCLUSION: Our study findings indicate a need to provide social support for preventing and alleviating violence responses of psychiatric nurses.
Friends ; Hospitals, Psychiatric ; Humans ; Linear Models ; Methods ; Psychiatric Nursing ; Violence

PURPOSE: The purpose of this study was to examine the impact of autonomy, competence, and relationship on the recovery attitude of inpatients with alcohol use disorder.METHODS: This descriptive correlational study was based on the basic psychological needs theory, which is a sub-theory of self-determination theory (SDT). Study participants were 158 inpatients with alcohol use disorder from four mental hospitals in two areas. Data were collected from self-report questionnaires administered in September and October 2019. Data were analyzed using the t-test, one-way ANOVA, Pearson's correlation coefficients, and the multiple linear regression with IBM SPSS 22.0.RESULTS: Recovery attitude showed a positive correlation with autonomy (r=.62, p < .001), competence (r=.40, p < .001), and relationship (r=.33, p < .001). The results of the regression indicate the autonomy and competence explained 39% of the recovery attitude (R2=.40, F=51.04, p < .001).CONCLUSION: The results suggest that autonomy and competence play integral roles in the recovery attitude of inpatients with alcohol use disorders. Thus, mental health practitioners should develop psychological need-based interventions to improve the autonomy, competence, and recovery attitude of inpatients' with alcohol use disorder.
Alcoholism ; Health Services Needs and Demand ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Inpatients ; Linear Models ; Mental Competency ; Mental Health ; Motivation

PURPOSE: The purpose of this study was to explore the therapeutic communication experience of nurses in psychiatric wards.METHODS: Data were collected from 9 mental health nurses working at psychiatric wards in three university hospitals in Seoul and Gyeongju, South Korea. The study involved in-depth individual interviews, which were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.RESULTS: Therapeutic communication experiences of psychiatric ward nurses were categorized into 4 categories, 12 subcategories, and 24 codes. The four categories were ‘therapeutic communication practiced as a nurse’, ‘therapeutic communication delivered to patients’, ‘power revealed between patients and nurses’, and ‘environment surrounding therapeutic communication’. The twelve subcategories were ‘approaching with interest’, ‘with all one's heart and soul’, ‘learning and grow from peers’, ‘understanding the true meaning of mental health nursing’, ‘boosting in strength’, ‘providing a sense of security’, ‘formation of rapport’, ‘lead to recovery’, ‘variability of interaction’, ‘powerful energy originating from sparklet’, ‘lack of physical time’, and ‘absence of supervision’.CONCLUSION: The results of this study indicate the need to develop and apply therapeutic communication interventions for psychiatric nurses. Supervision is needed to promote therapeutic communication among psychiatric nurses and requires institutional support.
Gyeongsangbuk-do ; Heart ; Hospitals, University ; Humans ; Korea ; Mental Health ; Organization and Administration ; Psychiatric Nursing ; Qualitative Research ; Seoul

PURPOSE: The purpose of this mixed-method study was to identify the demand for mental health nursing education and work of nurses at a private psychiatric hospital.METHODS: The survey of demand for mental nursing education was conducted by including 231 nurses at a private psychiatric hospital from November to December, 2017. Qualitative research by two focus groups was conducted from October to November, 2018.RESULTS: The mean of mental health nursing education demands according to major category were the therapeutic environment (4.27±0.76), substancerelated and addictive disorders (4.18±0.68), therapeutic relationship and communication (4.17±0.64), respect for human (4.11±0.74), and neurocognitive disorders (4.07±0.74). The qualitative research participants’ demands for mental health nursing education were classified into five categories: ‘discrimination power’, ‘communication techniques’, ‘psychiatric drugs’, ‘coping method’, and ‘legal issues’.CONCLUSION: Nurses with less psychiatric careers have strong need to learn a therapeutic environment and alcoholism, and nurses with more experience in psychiatry have education of humanities. Nurses at private psychiatric hospitals have high demand for continous education of updated mental nursing to expand their extensive experience required for becoming more professional nurses in future.
Alcoholism ; Education ; Education, Nursing ; Focus Groups ; Hospitals, Psychiatric ; Humanities ; Humans ; Mental Health ; Methods ; Neurocognitive Disorders ; Nursing ; Psychiatric Nursing ; Qualitative Research

OBJECTIVES: To identify factors related to physical health monitoring of patients with schizophrenia spectrum disorder. METHODS: A total of 172 patients with schizophrenia spectrum disorder registered in mental health welfare centers and rehabilitation facilities in Gwangju were recruited. Physical health monitoring was defined by two health behaviors; fasting blood tests within recent 2 years in all participants and routine medical check-ups covered by national insurance within recent 5 years in participants aged 40 years or older. Demographic and clinical characteristics including overweight, metabolic syndrome and knowledge about physical illness were compared according to physical health monitoring. RESULTS: Prevalence of overweight and metabolic syndrome were 62.8% and 40.1%, respectively. The rates of fasting blood tests and routine medical check-ups were 34.9% and 67.9%, respectively. The rates of fasting blood tests were significantly higher in general hospital and university hospital compared to mental hospital or private clinic. Rates of routine medical check-ups were significantly lower in individuals using daily rehabilitation service and smokers. Knowledge about cancer and chronic illness were significantly better in individuals receiving routine medical check-ups compared with those not receiving it. CONCLUSION: Education about physical health should be integrated to mental health service in community mental health center.
Chronic Disease ; Education ; Fasting ; Gwangju ; Health Behavior ; Hematologic Tests ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Insurance ; Mental Health ; Mental Health Services ; Overweight ; Prevalence ; Rehabilitation ; Schizophrenia ; Smoking

OBJECTIVES: The authors evaluated the environment and conditions of Korean psychiatric residents to identify important factors for them in determining their satisfaction with training programs. METHODS: Questionnaires on the residency training program were administered to 513 Korean psychiatric residents from 2016 to 2017. The questionnaire was composed of sociodemographic background, work environment and status of the training program. The authors analyzed questionnaire according to the residents' grade and hospital type and identified the significant factors for satisfaction with their training. RESULTS: Compared to the 1st grade, the 4th grade psychiatric residents have significantly less working time, duty days, and more sleep time, mealtime, and annual salary. In the hospital type, the residents of general hospitals and university hospitals have more working time, annual salary, and accessibility to educational material than mental hospitals. The satisfaction with their training is higher in the 1st grade than in the 4th grade, in those with more than six hours of sleep time, and in residents who are satisfied with the accessibility of educational materials. CONCLUSION: Compared to the 1st grade, the working intensity of 4th grade psychiatric residents is lower and their welfare is better. To improve the satisfaction with the training program, it is necessary to make efforts to increase the sleep time of residents, improve the accessibility of educational material, identify the problem of the training program, particularly in the 4th grade, and make institutional improvements.
Education ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Internship and Residency ; Meals ; Salaries and Fringe Benefits

BACKGROUND: As society is aging, the number of elderly patients with psychiatric disorder, such as dementia, is increasing. The hospitalization period of elderly patients in psychiatric wards tends to be prolonged. In this study, we have determined the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients in Japan. METHODS: The information was collected from patients admitted to our hospital's emergency ward for elderly patients with psychiatric disorders between May 2015 and April 2016. We compared various factors between the early discharge group and the non-early discharge group. In addition, we used a multiple logistic regression model to clarify the risk factors for non-early discharge. RESULTS: Of the 208 elderly patients, body mass index (BMI) and serum albumin level were significantly lower in the non-early discharge group. In addition, we also showed that higher serum C-reactive protein (CRP) (> 0.5 mg/dL) and use of seclusion or physical restraint significantly inhibited the early discharge of patients. The results of multiple logistic analysis showed that the BMI ≤ 17.5 kg/m (OR, 2.41 [95% confidence interval (CI) 1.06-5.46]), serum albumin level ≤ 30 g/L (OR, 3.78 [95% CI 1.28-11.16]), and use of seclusion or physical restraint (OR 3.78 [95% CI 1.53-9.37]) are particularly important explanatory factors. CONCLUSIONS Hypoalbuminemia, low BMI, and the use of seclusion or physical restraint were identified as the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients. These factors reflect malnutrition and extremely serious psychiatric symptoms.
Aged ; Aged, 80 and over ; Dementia ; diagnosis ; psychology ; therapy ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Hospitals, Psychiatric ; statistics & numerical data ; Humans ; Japan ; Length of Stay ; statistics & numerical data ; Male ; Patient Discharge ; statistics & numerical data ; Risk Factors

OBJECTIVES: This study aimed to investigate the relationship between depressive and anxiety symptoms and tardive dyskinesia (TD) and reveal the association of cognitive function and TD in patients with schizophrenia. METHODS: We recruited 30 schizophrenia patients with TD and 31 without TD from a national mental hospital in South Korea. To assess depressive and anxiety symptoms, the Beck Depression Inventory-II (BDI–II) and the Beck Anxiety Inventory (BAI) were conducted. Using the five-factor structure of the BDI-II and BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety were assessed. Computerized neurocognitive function test (CNT) was performed to assess levels of cognitive functions. We compared the clinical characteristics, levels of cognitive functions, and depressive and anxiety symptoms between schizophrenia patients with TD and without TD. Chi-square test, Fisher's exact test, independent t-test and Mann Whitney U test were conducted to compare two groups. Pearson correlation analysis was conducted to evaluate relationships among the abnormal involuntary movement scale (AIMS), BDI-II, BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety. RESULTS: The subjects with TD had significantly lower score on the cognitive depression than those without TD (t = −2.087, p = 0.041). There were significant correlations between the AIMS score and the BDI-II score (r = −0.386, p = 0.035) and between the AIMS score and cognitive depression score (r = − 0.385, p = 0.035). CONCLUSIONS: Our findings suggest the inverse relationship between severities in TD and depression and support the assumption that there is an inverse relationship between the pathophysiology of TD and depression.
Abnormal Involuntary Movement Scale ; Anxiety ; Cognition ; Depression* ; Hospitals, Psychiatric ; Humans ; Korea ; Movement Disorders* ; Schizophrenia*

OBJECTIVE: It investigated the tendency of the increase of elderly patients in a psychiatric hospital. In this regard, it examined whether the number of patients with outpatient consultant, discharge, medical diseases, and neurocognitive disorder increased or not. METHODS: It retrospectively reviewed inpatient medical records for the years 2008, 2011, 2014, 2017. To investigate the changes of elderly patients admitted to psychiatry, it examined the changes of patients who are older than 50 or 60 years in addition to the people who are older than 65 years. It analyzed diagnosis, discharge, medical diseases, and outpatient consultant of the three groups respectively. RESULTS: It confirmed that the number of elderly patients who are older than 50, 60, and 65 years has increased in mental hospital for 10 years. There was a significant increase in the number of neurocognitive disorder patients, the ratio of consultant outpatient, and the mean number of outpatient consultant. Diabetes increased in all three groups. Especially it has significantly increased for patients who are older than 50 and 60 years. In the case of patients discharged due to transfer, the number of patients increased in all three groups but it was statistically significant for the patients who are older than 50 years. CONCLUSION: The study shows that the number of elderly patients increased with the trend of aging society. In relation to this, the rate of outpatient consultant and discharge, including diabetic and dementia patients, also increased. Therefore, if the mental health department provides a system to manage the elderly ward or nursing ward to respond to the increase of elderly patients, or to manage the accompanying chronic diseases such as diabetes and its complications, it could solve the inconvenience of patients due to the consultation outside a hospital or discharge.
Aged* ; Aging ; Chronic Disease ; Consultants ; Dementia ; Diagnosis ; Hospitals, Psychiatric* ; Humans ; Inpatients ; Medical Records ; Mental Health ; Neurocognitive Disorders ; Nursing ; Outpatients ; Retrospective Studies

Although seclusion and restraint are required for the treatment of mentally ill patients in psychiatric hospitals, these procedures involve potential violations of human rights and pose a potential risk to patients' physical condition. Nursing staffs in psychiatric hospitals often have to manage psychiatric patients who display aggressive, violent, or challenging behavior. However, the guidelines for the use of seclusion and restraint in Korea are too broad to apply in clinical situations. The guidelines in the United States, Australia, the United Kingdom, and New Zealand emphasize that patients' basic needs have to be met and stipulate that patient–staff interaction must be continued during seclusion and restraint procedures. Mental health workers in psychiatric hospitals should pay close attention to patients' verbal and non-verbal expressions while communicating with them. This study reviews the guidelines for seclusion and restraint used in foreign countries to improve current Korean guidelines and provides strategies of the nursing activities to be implemented when patients require seclusion and restraint.
Australia ; Great Britain ; Hospitals, Psychiatric ; Human Rights ; Humans ; Korea ; Mental Health ; Mentally Ill Persons ; New Zealand ; Nursing Staff ; Nursing ; Psychiatric Nursing ; United States