Perceptions of professional role in community mental health nurses: The interplay of power relations between nurses and mentally ill individuals

Karanikola, Maria; Kaikoushi, Katerina; Doulougeri, Karolina; Koutrouba, Anna; Papathanassoglou, Elizabeth

doi:10.1016/j.apnu.2018.03.007

Cited by 6 publications

(8 citation statements)

References 24 publications

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“…A total of three articles met the inclusion criteria (Coffey & Jenkins, 2002; Karanikola et al., 2018; Magnusson et al., 2004). All three studies discussed ethical issues associated with the provision of mental health care by nurses in community mental health settings and included the concept of coercion.…”

Section: Resultsmentioning

confidence: 99%

“…When nurses first start to practice in community mental health settings, they may find it difficult to relinquish the levels of control they exercised in institutional settings (Magnusson et al., 2004). The loss of an authority that is automatically ascribed in hospital‐based settings was regarded as the greatest challenge to the professional role of a community mental health nurse (Karanikola et al., 2018). This ‘reversed power dynamic’ may require nurses to ‘subtly control’ the situation to develop the therapeutic alliance (Karanikola et al., 2018).…”

Section: Resultsmentioning

confidence: 99%

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Ethical challenges for nurses delivering coercive interventions in community mental health settings: A scoping review

Haines,

Stanton,

Anderson

et al. 2024

Int J Mental Health Nurs

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The number of Australians subject to coercive interventions in community mental health services continues to increase. This is in the context of a growing awareness of the harms from coercion, increasing concerns about potential breaches of human rights and an ongoing uncertainty regarding the clinical benefits of community treatment orders, the primary instrument of legislated coercion in community mental health services. Nurses in community mental health services are on the frontline with regard to coercion. They police the requirements of the community treatment order, administer medication to people in community settings without their consent and facilitate re‐hospitalisation if indicated. Coercive practice contradicts the person‐centred, recovery‐oriented and trauma‐informed care principles that inform contemporary mental health nursing. This contradiction may generate ethical challenges for nurses and result in ethical distress. The aim of this scoping review was to map the research literature on how nurses in community mental health settings recognise and manage the harm associated with the administration of coercive interventions and consider the ethical challenges that may arise within this practice. The search strategy yielded 562 studies with author consensus determining a total of three articles as meeting the inclusion criteria. The resulting literature identified three themes: (1) maintaining the therapeutic relationship, (2) promoting autonomy and (3) using subtle forms of control. This review demonstrated that there is minimal research that has considered the ethical challenges related to the use of coercion by nurses in community mental health settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Ethical challenges for nurses delivering coercive interventions in community mental health settings: A scoping review

Haines,

Stanton,

Anderson

et al. 2024

Int J Mental Health Nurs

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“…First, psychiatric nurses have described that, while working in outpatient care, the roles of professionals and patients may interchange, and patients can become the more commanding actor (Karanikola et al . 2018). At the same time, hospital care seems to entail deeply structured hierarchical systems (Griscti et al .…”

Section: Discussionmentioning

confidence: 99%

Facilitators for improvement of psychiatric services and barriers in implementing changes: From the perspective of Finnish patients and family members

Anttila

Varpula

Välimäki

2020

Int J Mental Health Nurs

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The need for psychiatric patients and their family members to have access to quality user‐friendly services has been studied for decades, yet few improvements have been made in treatment services. This study aims to explain how patients and family members have experienced facilitators of improvements, and their thoughts about barriers in the implementation of changes. An explanatory qualitative design was adopted. Data were collected using semi‐structured interviews with eight focus groups made up of a total of 35 participants from mental health associations in Finland. The Theoretical Domains Framework guided the deductive data analysis. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) was followed in the study. Participants in patient and family member associations had similar experiences and thoughts about facilitators of improvements in psychiatric services and barriers in the implementation of changes. For example, both participant groups experienced that promoting more positive roles of professionals could facilitate improvements in psychiatric care. On the other hand, a lack of theoretical competence and interpersonal skills of professionals could hinder change. We conclude that many of the facilitators that patients and families suggested could be addressed by enhancing collaboration and communication, having a more person‐centred approach, focusing on recovery throughout the course of care, and acknowledging staff’s well‐being at work. Second, the barriers to implementing changes centre around the limited knowledge and skills of staff, and a paternalistic system that focuses on managing risk and administering treatment.

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“…Petugas kesehatan dalam menjalankan program kesehatan jiwa perlu adanya pengalaman agar dapat dengan mudah menyelesaikan tugas. Peneliti sebelumnya menyatakan bahwa pentingnya pengalaman klinis yang dimiliki petugas kesehatan menjadi sorotan dalam mengelola kebutuhan pasien secara efektif dan hasil yang optimal (Karanikola et al, 2018). Kejadian yang pernah dirasakan atau dialami dapat dijadikan sebuah pembelajaran untuk mengasah softskill, Potensi dan mampu menjalankan pekerjaan dengan baik sehingga meningkatkan kinerja perawat kesehatan jiwa dalam memberikan pelayanan kesehatan yang sesuai.…”

Section: Pendahuluanunclassified

Pengalaman Petugas Kesehatan Jiwa Dalam Menangani Orang Dengan Gangguan Jiwa (Odgj) Di Puskesmas Kabupaten Lamongan

Lestari

Yusuf²,

Tristiana³

2020

PNJ

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Pendahuluan: Pengalaman petugas kesehatan jiwa dapat mempengaruhi kualitas pelayanan kesehatan jiwa. Petugas kesehatan jiwa memiliki berbagai hambatan dalam menangani pasien gangguan kesehatan jiwa. Tujuan dari penelitian ini adalah untuk menggali pengalaman petugas kesehatan jiwa dalam menangani ODGJ di Puskesmas Kabupaten Lamongan.Metode: Penelitian ini menggunakan desain penelitian kualitatif fenomenologi. Pengambilan sampel dilakukan dengan purposive sampling dengan jumlah sampel 15 partisipan. Data dikumpulkan dengan menggunakan observasi dan wawancara mendalam semi terstruktur. Analisis tematik dilakukan menggunakan langkah-langkah Colaizzi.Hasil: Pengalaman petugas kesehatan jiwa meliputi hambatan, motivasi dan cara mengatasi hambatan dalam menangani pasien gangguan jiwa. Hambatan yang dihadapi petugas kesehatan jiwa berasal dari ODGJ yang tidak mau minum obat dan melakukan kekerasan secara fisik maupun verbal terhadap petugas kesehatan jiwa, selain itu kurangnya dukungan keluarga dan SDM yang kurang sehingga petugas kesehatan mengalami kesulitan dalam merawat ODGJ, namun dapat diatasi dengan motivasi yang tinggi dari petugas kesehatan jiwa dalam merawat pasien gangguan jiwa, kerjasama dengan lintas sektor, meningkatkan kualitas SDM dengan pelatihan CMHN, sosialisasi di masyarakat dan pendekatan kepada keluarga.Kesimpulan: Pengalaman dapat mempengaruhi tingkat pengetahuan dan kemampuan petugas kesehatan jiwa dalam menangani ODGJ. Hasil penelitian ini diharapkan dapat digunakan sebagai data penunjang maupun acuan dalam meningkatkan kualitas pelayanan kesehatan jiwa khususnya di wilayah kerja puskesmas ABSTRACTIntroduction: The experience of a mental health practitioners can affect the quality of mental health services. Mental health practitioners have various obstacles in the treatment of mental disordered patients. The aim of this research is to know the experience mental health on treating mental disordered patients in health center.Method: This study uses qualitative research with a phenomenological approach. Sampling was conducted by purposive sampling with a sample size of 15 participants. Data were collected using with observation and semistructured in-depth interview. Thematic analysis was performed using Colaizzi steps.Results: The experience of mental health practitioners includes obstacles, motivation, and ways to overcome obstacles in dealing with mental patients. Obstacles faced by mental health practitioners come from mental disorders patients who do not want to take medicine and do physical or verbal violence against mental health workers, besides the lack of family support and lack of human resources so that health practitioners have difficulty in caring for mental disorders patients, but can be overcome with motivation education of mental health practitioners in treating mental patients, collaboration with cross-sectoral, improving the quality of human resources with CMHN training, socialization in the community and approach to the family.Conclusion: Experience can affect the level of knowledge and ability of mental health practitioners in handling mental disordered patients. The result of this research is expected to be used as both supporting data and references in increasing the quality of mental health service especially in health center work area.

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Perceptions of professional role in community mental health nurses: The interplay of power relations between nurses and mentally ill individuals

Cited by 6 publications

References 24 publications

Ethical challenges for nurses delivering coercive interventions in community mental health settings: A scoping review

Ethical challenges for nurses delivering coercive interventions in community mental health settings: A scoping review

Facilitators for improvement of psychiatric services and barriers in implementing changes: From the perspective of Finnish patients and family members

Pengalaman Petugas Kesehatan Jiwa Dalam Menangani Orang Dengan Gangguan Jiwa (Odgj) Di Puskesmas Kabupaten Lamongan

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