Development and Validation of the Performance-Based Situation Awareness Observation Schedule (PBSAOS): The Process and Lessons Learned.

BACKGROUND: No instruments are currently available to assess nursing students' maintenance of situation awareness. The aim of this study was to develop and validate the Performance-Based Situation Awareness Observation Schedule for measuring nursing students' use of situation awareness. METHOD: Twelve expert clinicians participated in a qualitative, reiterative consensus-driven process to establish the content validity of the tool. The tool was then piloted during the delivery of a situation awareness education program for final-year nursing students. Cohen's kappa was used to assess the interrater reliability. RESULTS: The resultant tool comprised 54 items, which captured strategies to maintain situation awareness and task errors that would infer the presence of situation awareness. The values obtained for Cohen's kappa indicated that the level of agreement was at least substantial for approximately 80% of the items. CONCLUSION: This study developed a valid and reliable tool to measure nursing students' use of situation awareness. [J Nurs Educ. 2019;58(8):468-473.].

Australian mental health caregiver burden: a smallest space analysis.

OBJECTIVES: To explore Australian mental health carers' prioritisation of key elements of caregiving and establish the extent to which particular issues contribute to carer burden. DESIGN: Cross-sectional survey. SETTING: All Australian States and Territories. PARTICIPANTS: Responses were received from 231 Australian mental health caregivers. MAIN OUTCOME MEASURES: The Involvement Evaluation Questionnaire was used to assess caregiver burden. RESULTS: Smallest space analysis identified three distinct regions, which we conceptualise as: 1) promoting the safety and health of mental health consumers; 2) impact of caring on caregivers' personal lives and 3) enabling daily living functional recovery of mental health consumers. The analysis demonstrates that carers are most concerned with enabling daily living functional recovery, for which the mean value was considerably higher than the personal impact and promoting safety and health regions. In terms of the individual questionnaire items, the issues of most importance are assisting with self-care, worrying about consumers' future, finances and general health, encouraging consumer involvement in activities and concerns over the treatment consumers are receiving. CONCLUSION: Caregiving often came at significant personal cost. The burden that results from caring for mental health consumers could perhaps be alleviated through the expansion of psychiatric disability services, increasing government financial support and providing tailored psychosocial interventions that meet the needs of families.

The association between gratitude and burden in Australian mental health carers: a cross-sectional study.

The level of carer burden has increased as carers take on more responsibility for mental health consumers as a result of the contemporary shift in the delivery of services from institutional to community settings. Interventions are required to mitigate mental health carer burden. Therefore, we examined the association between dispositional gratitude and burden in a cross-sectional survey of 231 Australian mental health carers. Dispositional gratitude was assessed by the S-GRAT, and carer burden was measured using the Involvement Evaluation Questionnaire. The results of a general linear model demonstrated that higher levels of a lack of sense of deprivation were significantly associated with lower levels of tension, worrying and urging. In contrast, higher levels of simple appreciation were significantly associated with higher levels of supervision, worrying and urging. Our findings highlight that gratitude interventions should focus on promoting a lack of sense of deprivation and appreciation of others in order to reduce mental health carer burden.

Antipsychotic medication side effect assessment tools: A systematic review.

OBJECTIVE: The aim of this systematic review was to critically appraise the psychometric properties of antipsychotic medication side effect assessment tools. METHODS: Systematic searches were undertaken in PubMed, CINAHL and CENTRAL from inception to October 2014. Studies were included if they detailed the evaluation of psychometric properties of antipsychotic medication side effect assessment tools in mental health populations. Studies were excluded if they examined the use of antipsychotic medication side effect assessment tools in non-mental health populations, including people suffering from dementia, Parkinsonism and Alzheimer's. Narrative reviews and studies published in any language other than English were also excluded. RESULTS: Content validity was appropriately established for only one of the tools, reliability was inappropriately evaluated for all but one tool, and the assessment of responsiveness was not acceptable for any tool. CONCLUSION: Further psychometric studies are warranted to consolidate the psychometric properties of the included antipsychotic medication side effect assessment tools before any of these tools can be confidently recommended for either research or clinical purposes.

Australian case managers' perceptions of mental health consumers use of antipsychotic medications and associated side-effects.

The present study explores Australian case managers' perceptions of mental health consumers' use of antipsychotic medications and the side-effects resulting from these medications. Semistructured interviews were used to elicit material from nine case managers in a community care setting in South-East Queensland, Australia. Content analysis was used to examine the transcripts, and the audio-recordings were replayed to identify important contextual cues. The analysis identified several main themes, including perceptions of the use of antipsychotic medications and associated side-effects, the provision of information about antipsychotic medication side-effects; the assessment of antipsychotic medication side-effects; and the promotion of effective management of antipsychotic medication side-effects. The participants believed that antipsychotic medication provided clear benefits to mental health consumers. Most participants believed that consumers adapted to side-effects and came to accept them. The case managers themselves often felt poorly informed about antipsychotic medication side-effects, leading them to request more succinct types of information. It was notable to find that there was a lack of systematic approach to the assessment of side-effects. This finding highlighted the need to incorporate the routine structured assessment of antipsychotic medication side-effects in providing care to mental health consumers in the community.

Living with antipsychotic medication side-effects: the experience of Australian mental health consumers.

The present study explores people's experience of living with antipsychotic medication side-effects. Qualitative data were gathered through semistructured interviews with 10 mental health consumers in a community care setting in Australia. The interview transcriptions were content analysed, and enhanced by combining manifest and latent content. Important contextual cues were identified through replaying the audio-recordings. Several main themes emerged from the analysis, including the impact of side-effects, attitudes to the use of medication and side-effects, and coping strategies to manage medication side-effects. Each participant reported between six and seven side-effects on average, which were often pronounced and had a major disruptive impact on their lives. Of these effects, the most commonly mentioned was sedation, which the participants described as leaving them in a 'zombie'-like state. Most participants expressed an attitude of acceptance about the side-effects. The participants' most common strategy to manage side-effects was to change the dosage of the medication. Other common side-effect management strategies involved using other medications to control side-effects, and diverse self-help techniques, the most common of which was relaxation/distraction techniques.

Patient self-report measures of chronic pain consultation measures: a systematic review.

BACKGROUND: Earlier studies have associated improvements in chronic pain outcomes with various consultation attributes, including: the legitimization of people's chronic pain experience, affective components of the therapeutic relationship, and reaching decisions about people's care through collaboration. Although studies have used patient self-report measures to examine how certain aspects of consultations contribute to managing chronic pain. The psychometric quality of these measures seems to have not been independently appraised to date. OBJECTIVES: This review aimed to evaluate the psychometric properties and administrative feasibility of published patient self-report consultation measures that were validated for people with chronic pain. METHODS: Databases were searched to identify patient self-report consultation measures validated in chronic pain populations. Explicit review criteria for 8 measure attributes were developed for this review by synthesizing information from available guidelines. In total, 58 potentially relevant consultation measures were identified. Of these, 4 measures satisfied the inclusion/exclusion criteria and were critically appraised by 2 independent reviewers. Overall, the psychometric quality of the included measures was modest, particularly in terms of evidence for content validity, test-retest reliability, responsiveness, and interpretability. DISCUSSION: Each of the included measures assessed differing aspects of consultations, and their potential clinical and research uses are discussed. Recommendations are made to improve the psychometric quality of the included measures. In summary, more psychometric research needs to be undertaken to improve the existing measures' quality and broaden the scope of chronic pain consultation measures before studies may be conducted to develop a comprehensive understanding of the manner in which consultation attributes influence chronic pain outcomes.