Scholarship in nursing: current view.

Knowledge, as it relates to scholarship, has traditionally been developed through research, which for years was viewed as the sole method of knowledge generation. An expanded view of scholarship was proposed by Boyer, and includes the scholarship of discovery, integration, teaching, and application. This broader framework of scholarship is more suited to today's world. The aim of this paper is to provide clarification regarding the definition and criteria of scholarship and the differences between scholarly activities and scholarship. Nurses are held to the same standards of knowledge generation as other disciplines. There should be clarity on differentiating scholarly activities from scholarship.

Gender-specific profiles of tobacco use among non-institutionalized people with serious mental illness.

BACKGROUND: In many countries, smoking remains the leading preventable cause of death. In North America, reductions in population smoking levels are stabilising and, in recent years, those involved in tobacco control programming have turned their attention to particular segments of society that are at greatest risk for tobacco use. One such group is people with mental illness. A picture of tobacco use patterns among those with mental illness is beginning to emerge; however, there are several unanswered questions. In particular, most studies have been limited to particular in-patient groups. In addition, while it is recognised that men and women differ in relation to their reasons for smoking, levels of addiction to nicotine, and difficulties with cessation, these sex and gender differences have not been fully explored in psychiatric populations. METHODS: Community residents with serious mental illness were surveyed to describe their patterns of tobacco use and to develop a gender-specific profile of their smoking status and its predictors. RESULTS: Of 729 respondents, almost one half (46.8%) were current tobacco users with high nicotine dependence levels. They spent a majority of their income on tobacco, and reported using smoking to cope with their psychiatric symptoms. Current smokers, compared with non-smokers, were more likely to be: diagnosed with a schizophrenia spectrum disorder (rather than a mood disorder); male; relatively young; not a member of a racialised group (e.g., Aboriginal, Asian, South Asian, Black); poorly educated; separated or divorced; housed in a residential facility, shelter, or on the street; receiving social assistance; and reporting co-morbid substance use. There is evidence of a gender interaction with these factors; in the gender-specific multivariate logistic regression models, schizophrenia spectrum disorder versus mood disorder was not predictive of women's smoking, nor was education, marital status or cocaine use. Women, and not men, however, were more likely to be smokers if they were young and living in a residential facility. CONCLUSION: For men only, the presence of schizophrenia spectrum disorder is a risk factor for tobacco use. Other factors, of a social nature, contribute to the risk of smoking for both men and women with serious mental illness. The findings suggest that important social determinants of smoking are "gendered" in this population, thus tobacco control and smoking cessation programming should be gender sensitive.

Psychiatric patients: how can we decide if you are in pain?

How do psychiatric nurses make decisions about pain management for hospitalized psychiatric patients? This is the question addressed by this research. Using an exploratory, naturalistic interview approach, 20 nurses and managers in varied settings described their decision making when providing pain relief. Analysis of these narratives indicates that decision making about pain, in this unique context, is influenced by a number of intrapersonal and interpersonal factors such as the patients' needs, history, and diagnosis; nurses' beliefs about pain tolerance and drug addiction; collegial pressure; and unit safety. For example, diagnosis and patient history impact pain relief negatively, while the responsibility to maintain a safe environment imposes pressure to administer medication. Although, in a psychiatric unit, the nurse-patient relationship is essential to the healing process, nurses often face a dilemma as to whether the pain medication will contribute to healing or exacerbate the patient's issues. In psychiatric wards, the means of recovery are far less clear, tangible, and immediate than in other clinical settings. Recommendations are made for better preparing and supporting nurses to work effectively in these practice settings where pain relief is confounded by addiction and psychiatric diagnoses.

Community mental healthcare providers' attitudes and practices related to smoking cessation interventions for people living with severe mental illness.

OBJECTIVE: This study aimed to describe mental healthcare providers' attitudes about tobacco use, their personal smoking status, their confidence in offering smoking cessation support to clients living with severe mental illness, and the extent to which they incorporated smoking cessation interventions into their practice. The study also aimed to determine whether the providers' attitudes, smoking status, and confidence were associated with offering smoking cessation support to clients. METHODS: Self-administered questionnaires were distributed within community-based mental health agencies to those who provide care and support to adults living with severe mental illness. Outcomes measured included respondents' smoking status, attitudes related to the provision of smoking cessation support, confidence in providing smoking cessation intervention, and smoking cessation practices. We conducted multivariate analyses using logistic regression analyses to examine the factors associated with the providers' tobacco-related practices. RESULTS: In total 282 of 871 care providers responded to the survey, 22% of whom were current smokers. The providers who held sympathetic attitudes about their role and their clients' role in smoking cessation, who were never or former smokers, who were healthcare professionals rather than paraprofessionals, who had relatively more confidence, and who had more experience working in the mental health field were more likely to engage their clients in tobacco-related interventions. CONCLUSIONS: In this study the healthcare providers working in community-based mental health have a smoking prevalence rate that exceeds that of the region's general population and did not provide optimal smoking cessation support to their clients. PRACTICE IMPLICATIONS: Interventions that bolster the confidence of providers to engage is smoking cessation activities and that support a shift in attitudes about the role of tobacco use in mental health are required.