Changes in People with Schizophrenia during the COVID-19 Pandemic: An Integrative Review / 정신간호학회지

Purpose@#This integrative review aims to identify changes in people with schizophrenia during the COVID-19 pandemic. @*Methods@#An integrative literature review method of Whittemore and Knafl was applied to integrate the studies. The literature search was conducted in six electronic databases using English and Korean search terms. Three researchers independently reviewed the extracted papers and rated their quality based on predetermined inclusion and exclusion criteria. A total of fifteen relevant studies were included. @*Results@#The selected articles were all international papers, and most of them were quantitative studies. The changes observed in people with schizophrenia were summarized as follows: (1) changes in health outcomes: psychosocial (increased levels of depression, stress, anxiety, sleep disturbance, and psychotic-like experience) and physical (reduction in food intake, weight loss, changes in immunerelated clinical values, etc.); (2) changes in treatment and health management: increased hospitalization, decreased ICU hospitalization, and a decrease in outpatient visits and prescription rate. @*Conclusion@#This study confirmed the impacts of the COVID-19 pandemic on people with schizophrenia. It is necessary to develop mental health policies and appropriate nursing interventions to help people in preparing for possible future crises.

Exploring the Therapeutic Communication Practical Experience of Mental Health Nurses / 정신간호학회지

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.

Difficulties in Caring for Psychiatric Patient as Experienced by Non-Psychiatric Nurses

PURPOSE: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. METHODS: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were ‘nurse’ related factors, ‘patient’ related factors, ‘resource’ related factors. The nine categories were ‘unpreparedness’, ‘nursing barriers due to stigma’, ‘undervaluing and avoidance of psychiatric nursing’, ‘eroding into the trap of a vicious cycle’, ‘facing unapproachable patients’, ‘dealing with unhelpful family members’, ‘burdening already overburdened staff’, ‘obstructive environment’, and ‘isolation of staff with heavy responsibilities’. CONCLUSION: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

Effects of a Relapse Prevention Program on Insight, Empowerment and Treatment Adherence in Patients with Schizophrenia

PURPOSE: The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA. RESULTS: The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups. CONCLUSION: Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.