Background: There are several metrics for determining cultural competency in nurses, but none of them apply to Filipino nurses caring for patients with mental health issues in the Philippines setting. Purpose: The goal of this study was to create a cultural competency tool for Filipino nurses (CCTFN) caring for patients with mental health issues in hospitals, communities, or schools. Methodology: A sequential exploratory design was used. The qualitative phase utilized a scoping review and guided interviews, followed by the quantitative phase involving the validity test by five experts and the reliability tests participated by 140 nurses in Zamboanga City. IBM SPSS Statistics 22.0 was used to examine the data. Results: The scoping review utilized PRISMA to search for eligible articles and the interviews resulted in an initial 51-item pool. The tool's content validity (S-CVI=0.992) was confirmed by a panel of experts. The inter-rater (ICC=0.773), inter-item (α =0.838) reliability, and exploratory factor analysis revealed four factors that accounted for 68.38 percent variance, resulting in 25 valid items. The four factors were “awareness on the Filipino concept of mental illness,” “attitudes towards fostering an efficient relationship between patient with mental health problems and self,” “skills in addressing cultural needs and issues of patients with mental health problems,” and “knowledge on socio-political factors affecting patients with mental health problems.” Conclusion/Implications for Practice Overall, the CCTFN was found to be valid and reliable. This tool can improve nursing care and inform training programs in the Philippines to improve mental health service provision and reduce stigma.
Cultural Competency ; Psychiatric Nursing

The increasing demand for mental health services worldwide and the continuing development of government policies for mental health require a huge contribution from psychiatric mental health nurses. However, previous studies reveal that the roles of psychiatric mental health nurses lack distinctiveness compared with other members of the health care team; thus the need for clearer identification of their role. This study intended to describe the perceived roles of psychiatric mental health nurses in selected hospital-based psychiatric settings. Qualitative descriptive study design was used. A purposive sample of eleven (11) psychiatric mental health nurses and twelve (12) non-nurses (i.e. psychiatrists, clinical psychologists, social worker, and occupational therapists) participated in semi-structured interviews about their perceived roles of psychiatric mental health nurses. Content analysis was used to analyze the data. It was found out that the perceived roles of psychiatric mental health nurses are direct care provider, facilitator of family and therapeutic group activities, manager of therapeutic environment, educator, collaborator, patient advocate and researcher. It also showed that the roles of psychiatric mental health nurses are clearly established in hospital-based psychiatric settings and that the perception of psychiatric nurses about their roles is consistent with the roles that other mental healthcare professionals expect from them.
Occupational Therapists ; Psychiatric Nursing ; Psychiatry

PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.
Models, Structural ; Psychiatric Nursing

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

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 test the effects on stress and depression by developing and implementing an integrated stress management program for inpatients in the psychiatric closed ward. METHODS: The study was a one-group pretest-posttest design. A total of 36 patients in the closed ward participated in this study. Data were collected through self-report questionnaires to measure hospital stress and depression. Data were analyzed by using t-tests and one-way ANOVA with SPSS/WIN 21.0. RESULTS: Integrated stress management program was designed based on Lazarus and Folkman stress-appraisal-coping model. Total of eight 1-hour sessions were delivered for four weeks in the group. There were significant differences in the inpatient stress scores before and after the intervention. However, the integrated stress management program showed some reduction in depression but did not show signifiant differences statistically. CONCLUSION: Our study findings confirm that the use of the integrated stress management program can reduce stress of the patients, that enable them to stabilize their minds at hospitalization. However, further study is needed to confirm the effects on depression. Thus, it would be beneficial to provide psychiatric nursing intervention tailored to psychiatric patients' symptoms, especially for reducing inpatient stress.
Depression ; Hospitalization ; Humans ; Inpatients ; Managed Care Programs ; Psychiatric Nursing ; Stress, Psychological

PURPOSE: The purpose of this study was to (1) develop an acceptance commitment therapy (ACT) based recovery enhancement program for inpatients with mental illness and (2) test the effects of the program on patients' psychological flexibility, recovery attitude, and quality of life. METHODS: A mixed methods design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 41 inpatients with mental illness (experimental group: 20, control group: 21). The ACT based recovery enhancement program was conducted over four sessions for a total of two weeks. Data were collected from December 2018 to January 2019. RESULTS: Study results revealed that the ACT based recovery enhancement program was effective for psychological flexibility (F=150.71, p<.001), recovery attitude (F=60.22, p<.001), and quality of life (F=31.59, p<.001) for inpatients with mental illness. CONCLUSION: The results of this study suggest that the ACT based recovery enhancement program can be used as an effective mental health nursing intervention for psychological flexibility, recovery attitude, and quality of life of inpatients with mental illness.
Acceptance and Commitment Therapy ; Data Collection ; Hospitalization ; Humans ; Inpatients ; Mental Disorders ; Pliability ; Psychiatric Nursing ; Quality of Life

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

PURPOSE: The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test. RESULTS: The experimental group showed a significant decrease in hospitalization stress (t=5.09, p < .001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894). CONCLUSION: The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.
Acceptance and Commitment Therapy ; Diagnosis ; Hospitalization* ; Humans ; Inpatients* ; Primary Health Care ; Psychiatric Nursing ; Schizophrenia* ; Self Efficacy ; Stress, Psychological