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PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask about child abuse. They often feel insufficiently competent to respond effectively to patients with a history of child maltreatment. PRACTICE IMPLICATIONS: Psychiatric nurses need training in how to assess a history of child abuse and the late-life consequences of abuse in adult psychiatric patients. They also need to be trained to respond effectively to these patients.
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To assess the validity and reliability of the Dutch version of the Oral HealthImpact Profile (OHIP-14) in a sample of patients of a forensic psychiatrichospital
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Higher and advanced vocational education prepare young adults for a career and enhance their life goals.The onset of mental illness generally occurs between 17 and 25 years. For young adults with psychiatric disabilities, educational resources are largely unavailable.
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People with psychiatric disabilities frequently experience difficulties in pursuing higher education. For instance, the nature of their disability and its treatment, stigmatization and discrimination can be overwhelming obstacles. These difficulties can eventually lead to early school leaving and consequently to un- or underemployment. Unfortunately, support services for (future) students with psychiatric disabilities are often not available at colleges and universities or at mental health organizations.For the social inclusion and (future) labor opportunities of people with psychiatric disabilities it is of the utmost importance that they have better access to higher education, and are able to complete such study successfully. Supported Education is a means to reach these goals. Supported Education is defined as the provision of individualized, practical support and instruction to assist people with psychiatric disabilities to achieve their educational goals (Anthony, Cohen, Farkas, & Gagne, 2002).The main aim of the ImpulSE project (see Appendix 1 for information about the project's organization) was the development of a toolkit for Supported Education services for (future) students with psychiatric disabilities. The toolkit is based upon needs and resources assessments from the four participating countries, as well as good practices from these.Secondly, a European network of Supported Education (ENSEd) is initiated, starting with a first International Conference on Supported Education. The aim of ENSEd is to raise awareness in the EU about the educational needs of (future) students with psychiatric disabilities and for services that help to remove the barriers for this target group.The toolkit is aimed at students’ counselors, trainers, teachers and tutors, mental health managers and workers, and local authority officials involved in policymaking concerning people with psychiatric disabilities. It enables field workers to improve guidance and counseling to (future) students with psychiatric disabilities, supporting them in their educational careers.In the Netherlands alone, it is estimated that six per cent of the total student population suffers from a psychiatric disability—that is, a total of 40,000 students. On a European scale, the number of students with a psychiatric disability is therefore considerably high. We hope that through the project these students will be better empowered to be successful in their educational careers and that their chances in the labor market and their participation in society at large will be improved.
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Abstract: Objective: The aim of this pilot implementation study was to explore the initial experiences with andimpact of Parenting with Success and Satisfaction (PARSS), a psychiatric rehabilitation and recoverybased,guided self-help intervention, for parents with severe mental illnesses. Methods: Changes in the PARSS intervention group were compared with changes in a control group in a nonequivalent controlgroup design. Outcome measures included: parenting satisfaction reported by parents; parenting success reported by mental health practitioners and family members; empowerment as reported by parents, practitioners and family members; and parents’ reported quality of life. Additional process data were obtained on relationship with practitioner, quality of contact, satisfaction with the intervention and fidelity. Results: Parenting satisfaction increased after 1 year for the PARSS group, but not for the control group. Parents’ reports of empowerment did not change for either group. The scores of parents’ empowerment reported by practitioners and family members increased in the control group, with no such change in the PARSS group. Quality of life improved significantly for the intervention group. Process measures showed that, although PARSS was not always implemented as intended, both parents and practitioners expressed satisfaction with the intervention. Conclusions and Implications for Practice: The first experiences with PARSS were mixed. This intervention, implemented by mental health practitioners, has the potential to function as a useful tool for supporting parents. Attention must be paid to enhancing intervention implementation and fidelity.doi: 10.1037/prj0000067PMID: 24866839
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The purpose of the Erasmus ImpuSE project is to develop and implement Supported Education services (Toolkit) in European countries and to establish a European Network Supported Education (ENSEd). Supported Education (SEd) is defined as the provision of individualized, practical support and instruction to assist people with psychiatric disabilities to achieve their educational goals ( Anthony et al., 2002). ImpulSE is an Erasmus Multilateral project (2013-2016) and is based in four countries: Czech Republic, Netherlands, Norway & Portugal.
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Abstract Introduction: In 2017, the role of coordinating practitioner was introduced in the Netherlands in order to improve quality of care for patients who receive treatment in specialized mental health care. Psychiatric-mental health nurse practitioners (PMHNPs) can fulfil this role. Aim/Question: The aim was to obtain insight into how PMHNPs fulfil the coordinating practitioner role and what is needed to improve fulfilment of this role. Method: A survey among PMHNPs in the Netherlands was conducted between July-September 2018. In total, 381 PMHNP filled out the questionnaire; the response rate was 47.6%. Descriptive analyses were performed using SPSS 22® (IBM). Results: 92% Of the PMHNPs fulfilled the coordinating practitioner role and were generally satisfied with their role performance. The following conditions were formulated to improve this role: 1) recognition and trust in the expertise of PMHNPs, 2) a clear description of their role as coordinating practitioner, 3) strengthening multidisciplinary collaboration, and 4) sufficient training budget and opportunities. Discussion: In Dutch mental health care, PMHNPs have strengthened their position as coordinating practitioner in a short period of time. Follow-up research should be conducted to obtain further insights into elements that contribute to an optimal role as coordinating practitioner. Implications for Practice: Having PMHNPs act as coordinating practitioners can contribute to solving the challenges in mental health care regarding coordination of care and effective multidisciplinary collaboration.
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Purpose Self-injury is common in forensic psychiatric settings. Recent research offers some insights into the functions and management of self-injurious behaviour but generally focusses on either the experiences of staff or patients. This study aims to explore the experiences of both staff and patients with non-suicidal self-injury in a Dutch forensic psychiatric hospital. Design/methodology/approach In total, 6 patients and 11 staff members were interviewed about the functions they ascribe to self-injurious behaviour, the emotional experience provoked by this behaviour and the management of self-injurious behaviour. The interviews were transcribed and analysed using a thematic analysis. Findings Four main themes resulted from the analysis: functions; emotional distancing; patient needs; and management. Overall, findings illustrate that staff reports limited knowledge of the different functions of self-injury. To circumvent potential automatic stereotypical judgement, staff should proactively engage in conversation about this topic with their patients. In managing self-injurious behaviour, clarity and uniformity among staff members should be promoted, and collaboration between the staff and patients is desirable. Staff recognised the potential benefit of a management guideline. Staff may find detached coping strategies to be effective but should be vigilant to not let this evolve into excessive detachment. Practical implications Increased knowledge and awareness of self-injury functions among staff can allow for better understanding and evaluation of self-injury incidents. Circumvention of automatic, stereotypical judgement of self-injurious behaviour is warranted, and more accessible explanations of the variety of functions of self-injury should be used. More proactive engagement in conversations about functions of self-injury by staff, can facilitate this. Detached coping can help staff to remain resilient in their job, but requires vigilance to prevent this from turning into excessive detachment. Clarity and uniformity among staff when managing self-injury incidents is considered beneficial by both patients and staff. A guideline may facilitate this. When imposing restrictions on patients, staff should strive to establish collaboration with the patient in determining the course of action and ensure the restriction is temporary. Originality/value The impact of self-injurious behaviour on all those involved can be enormous. More research is needed into experiences of both patients and staff members regarding the impact, motivations, precipitants and functions of self-injurious behaviour, and effective treatment of it.
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Abstract Background: Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. As such discordance between young patients and clinicians may obstruct treatment adherence and compromise treatment outcomes, it is important to understand the factors associated with it. We therefore investigated the factors associated with patient–clinician discordance with regard to care needs in various areas of functioning. Methods: A cross-sectional study involving 244 children/adolescents aged 6–18 participating with their clinicians in treatment at a specialized mental healthcare center. As a previous study conducted by our research group had found the greatest patient–clinician discordance in three CANSAS care needs—“mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends”—we used univariable and multivariable statistics to investigate the factors associated with discordance regarding these three care needs. Results: patient–clinician discordance on the three CANSAS items was associated with child, parent, and family/social-context factors. Three variables were significant in each of the three final multivariable models: dangerous behavior towards self (child level); severity of psychiatric problems of the parent (parent level); and growing up in a single-parent household (family/social-context level). Conclusions: To deliver treatment most effectively and to prevent drop-out, it is important during diagnostic assessment and treatment planning to address the patient’s care needs at all three levels: child, parent and family/social context.
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