ABSTRACT
This mixed method study examines the prevalence of restraint usage; perception of nurses and doctors about the practice and whether they were trained to apply physical restraints. The physical restraint prevalence tools were used to observe 172 adult patients and conduct 47 chart audits in the medical-surgical wards and a psychiatric unit in November 2011. Focus group discussions with nurses and doctors were conducted. Quantitative data were analyzed using the SPSS and focus group discussions thematically analyzed. The prevalence of physical restraints between the medical-surgical wards was 75%. Nurses and medical doctors were not formally trained to apply restraint, and had learnt from peer observation. They expressed sadness, guilt, and fear when restraints are used and identified that inadequate institutional support existed. Restraint usage was high, and nurses and doctors experienced moral dilemma when they perceived that lack of formal training and inadequate institutional support may contribute to patient injury.
Subject(s)
Restraint, Physical/statistics & numerical data , Adult , Aged , Attitude of Health Personnel , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Pilot ProjectsABSTRACT
A recent Jamaican school-based survey revealed that 23.1% of 13-15 year-olds, had attempted suicide one or more times during the last 12 months. Research that links adolescent pregnancy and suicidal behaviour is lacking in Jamaica. Psychological distress and suicidal behaviours amongst pregnant adolescents elsewhere in the Americas has been documented at prevalence of between 13.3%-20%. The purpose of the study was to explore the experiences and the impact of pregnancy on pregnant adolescent psychological health. Individual interviews and focus groups were conducted with adolescents in two Jamaican antenatal clinics. One clinic was designed as a 'Teen Pregnancy Clinic' and the other used the standard antenatal clinic design. The following themes were identified: decision-making, resilience, social support, community support system, distress, and perceptions of service. Participants reported positively on the specific interventions tailored to their needs at the Teen Clinic. Although motherhood is valued, none of the pregnancies in this study were planned by the mother. Of the 30 adolescents interviewed, seven cases were referred for counseling due to their need for emotional and psychological support. One of the adolescents reported recent sexual violence and another reported having experienced childhood sexual abuse. Historically, Jamaican adolescent mothers faced barriers to education, self determination, and family planning. Empowering, adolescent-centred healthcare and comprehensive reproductive health education may mitigate psychosocial distress.
Subject(s)
Mental Health , Mothers/psychology , Pregnancy in Adolescence/psychology , Adolescent , Counseling , Delivery of Health Care , Female , Health Services Needs and Demand , Humans , Jamaica , Life Change Events , Pregnancy , Self ReportABSTRACT
Anxiety disorders are prevalent in the school-aged population and are present across cultural groups. Scant research exists on culturally relevant prevention and intervention programs for mental health problems in the Aboriginal populations. An established cognitive behavioral program, FRIENDS for Life, was enriched to include content that was culturally relevant to Aboriginal students. Students (N = 533), including 192 students of Aboriginal background, participated in the cluster randomized control study. Data were collected three times over 1 year. A series of multilevel models were conducted to examine the effect of the culturally enriched FRIENDS program on anxiety. These analyses revealed that the FRIENDS program did not effectively reduce anxiety for the total sample or for Aboriginal children specifically. However, all students, regardless of intervention condition, Aboriginal status, or gender, reported a consistent decrease in feelings of anxiety over the 6-month study period.
Subject(s)
Anxiety/prevention & control , Cognitive Behavioral Therapy , Indians, North American/psychology , Anxiety/ethnology , Canada , Child , Culture , Female , Humans , Indians, North American/ethnology , Male , School Health Services , Sex Factors , Treatment OutcomeSubject(s)
Health Personnel/education , Inservice Training/organization & administration , Mental Health Services/organization & administration , Needs Assessment/organization & administration , Prejudice , Attitude of Health Personnel , Clinical Competence , Cultural Diversity , Curriculum , England , Guidelines as Topic , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Nursing Education Research , Program Evaluation , Race Relations/psychology , State Medicine/organization & administration , Total Quality ManagementABSTRACT
Recent events in the Newfoundland and Labrador healthcare system, including changes to nursing scope of practice, have had a profound effect on practice environments for direct care registered nurses (RNs) and Licensed practical nurses (LPNs). This article describes an initiative introduced by the Association of Registered Nurses of Newfoundland and Labrador (ARNNL) and the Council for Licensed Practical Nurses (CLPN) in response to concerns raised by healthcare providers related to collaboration and teamwork between RNs and LPNs. Through the Learning Circles Project, the ARNNL and CLPN committed to fostering an improved working relationship for nursing team members based on the values of working together, mutual respect and an enhanced working environment.
