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Identification of psychological morbidity in older people in primary care by practice nurses
- Authors:
- CAPE J., et al
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.446-451.
- Publisher:
- Taylor and Francis
Older people with psychological morbidity generally first present to health services in primary care, where they are increasingly seen by primary care nurses. In order to evaluate primary care nurses' identification of psychological morbidity, 190 older patients attending eight practice nurses completed the General Health Questionnaire (GHQ) and the practice nurses made an assessment as to the presence or absence of psychological problems. The practice nurses identified only 26% of probable cases of psychological morbidity identified by the GHQ. Their threshold for identification was high, rating only 12% of patients as experiencing psychological problems compared to 29% probable cases identified by the GHQ, and their accuracy was low (kappa for agreement between GHQ and nurse ratings = 0.23). Likelihood of identification depended on length and type of visit. The findings suggest that it may be unrealistic to expect practice nurses, without additional training and reorganisation of their work, to identify more than a minority of older patients with psychological morbidity in the course of their routine work.
Comparison of the assessment by doctors and nurses of deliberate self-harm
- Author:
- WESTON Sian Nerys
- Journal article citation:
- Psychiatric Bulletin, 27(2), February 2003, pp.57-60.
- Publisher:
- Royal College of Psychiatrists
The aim of this article was to compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment. There was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)). Further research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.
Learning disability nursing staff: a response to psychiatric teaching
- Authors:
- HAUT Fabian, HULL Alastair
- Journal article citation:
- British Journal of Learning Disabilities, 28(4), December 2000, pp.154-156.
- Publisher:
- Wiley
Learning disability nursing staff have an important role in the assessment and management of dual diagnosis patients. The present study assesses the level of psychiatric knowledge and interest of nursing staff in core psychiatric topics. Nursing staff were invited to attend a series of tutorials, and their knowledge of psychiatric topics was tested via a set of multiple-choice questions before and after the tutorials. The reasons for the low attendance rate and knowledge are discussed. Ensuring attendance is vital because the tutorials were found to be effective in improving knowledge.
Care out of chaos
- Author:
- HART Chris
- Journal article citation:
- Nursing Times, 24.11.99, 1999, pp.64-65.
- Publisher:
- Nursing Times
This article asserts that primary nursing could help bring therapeutic practice to deskilled and demoralised acute mental health wards.
Drawing the line
- Author:
- McEVOY Phil
- Journal article citation:
- Health Service Journal, 30.9.99, 1999, pp.28-29.
- Publisher:
- Emap Healthcare
The article discusses how psychiatric nurses have a valuable role in prioritising patients referred to community mental health teams. Employing community psychiatric nurses to assess clients referred to community psychiatric teams can help target resources. Includes a study of the impact of mental health assessment nurses on referral patterns.
Healing Jesus
- Author:
- LOVERIDGE Lisa
- Journal article citation:
- Nursing Times, 23.7.97, 1997, pp.26-30.
- Publisher:
- Nursing Times
'He thinks he's Jesus' is the sort of message A&E nurses used to dread, because it meant they were facing a problem for which they had no training. Explains how a nurse-led mental health liaison service can help.
Emergency action
- Authors:
- ROBERTS Mark, TAYLOR Bob
- Journal article citation:
- Nursing Times, 23.7.97, 1997, pp.30-32.
- Publisher:
- Nursing Times
Emergency psychiatric nurses provide liaison between accident and emergency and long-term care. This article outlines how they work.
Use of psychotropics among home-dwelling nondemented and demented elderly
- Authors:
- HARTIKAINEN Sirpa, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1135-1141.
- Publisher:
- Wiley
The home-dwelling elderly (n=523) among the random sample of 700 subjects from the total population of individuals aged 75 years or more in 1998 and living in the city of Kuopio, Finland. A trained nurse interviewed the participants about their health and current use of medicines. A geriatrician performed clinical examinations and diagnosed diseases. Dementia and depression were diagnosed according to the DSM-IV criteria. The demented subjects used more medicines of all kinds (p<0.01), and especially more psychotropics than the nondemented (p<0.001). One in four demented subjects, compared to one in ten nondemented ones used at least two psychotropics (p<0.01). The demented subjects used antipsychotics six times more often than the nondemented ones (p<0.001). Among the nondemented subjects, one out of two antipsychotics users was suffering from depression according to DSM-IV criteria. Three out of four persons who had dementia with Lewy bodies were using psychotropics. Persons with moderate dementia were more commonly using all kinds of psychotropic preparations especially, antipsychotics three times more commonly than persons with mild or severe dementia. Psychotropics, especially antipsychotics, are commonly used in the treatment of both nondemented and demented elderly, even without proper indication. Physicians need more training about the appropriate use of psychotropics to minimize their adverse effects.
Is education of health professionals encouraging stigma towards the mentally ill?
- Authors:
- SADOW Dolly, RYDER Marie, WEBSTER David
- Journal article citation:
- Journal of Mental Health, 11(6), December 2002, pp.657-665.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Students in a Boston area nursing school were offered the opportunity to take a battery of tests before and after receiving health education, training and experience. The battery included measures of overall attitudes towards the mentally ill, writing judgements about 'troubled people' in specific situations (a vignette instrument), a social desirability scale, a request for basic demographic information as well as information regarding previous contact with the mentally ill and a pilot measure of 'courtesy' stigma. 'Courtesy' stigma refers to the stigma attached to people associated with the mentally ill, such as mental health professionals. Health education and experience did not significantly affect attitudes towards the mentally ill but subjects overall rated mental health professionals more 'kindly' after being exposed to health education and experience. Students who had had a friend who was mentally ill prior to their school training showed a decrease in stigmatizing attitudes after being exposed to health education and experience whereas other students showed an increase. Other experience with the mentally ill, such as being co-workers on the job, did not have the same effect.
Finding and keeping: review of recruitment and retention in the mental health workforce
- Author:
- SAINSBURY CENTRE FOR MENTAL HEALTH
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 2000
- Pagination:
- 136p.,bibliog.
- Place of publication:
- London
This report aims to describe and analyse difficulties in recruiting and retaining mental health staff and to identify practicable and sustainable ways of addressing these difficulties. It presents conclusions from a review carried out by staff from the Sainsbury Centre for Mental Health and external consultants, and involved desk-based research and literature reviews on topics such as stocks and flows in the mental health workforce, problems with recruitment and retention, and possible solutions; advice from expert consultants; and fieldwork using focus group discussions with professional staff and managers. Staff groups covered are: psychiatrists, mental health nurses, social workers, clinical psychologists and occupational therapists.