The value of social media use in improving nursing students' engagement: A systematic review.

AIM: This systematic review was undertaken to investigate the impact of social media use in relation to student engagement in nursing education. BACKGROUND: The availability of social media has transformed global connectivity within education systems. Social media has been used in various educational contexts. The widespread use of social media has prompted a demand for a better understanding of how it might be used in nursing education. While research has previously explored the positive effects of using social media on a range of learning outcomes in nursing education, studies have not specifically focused on how these positive features have an impact on students' engagement as a vital component of successful learning. DESIGN: This review uses the Joanna Briggs Institute approach to conducting systematic reviews and follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting a systematic review. METHODS: Following predefined inclusion criteria, a search of electronic databases was performed using a three-step strategy to identify relevant studies. The following databases were searched: Cumulative Index of Nursing and Allied Health Literature (CINAHL), Education Resources Information Centre (ERIC), MEDLINE and PubMed. A further manual search was performed to identify potentially relevant articles. The included studies were assessed for methodological quality by all reviewers using the Mixed Methods Appraisal Tool. NVivo software was used for organising data and developing themes. RESULTS: Data from sixteen studies with different designs were extracted and thematically synthesised. The synthesised findings yielded five themes: 1) interaction and communication; 2) managing stress; 3) positive online community; 4) time spent; and 5) digital literacy and e-professionalism. CONCLUSIONS: This review reveals that using social media to support nursing students' learning has positive benefits in terms of promoting several aspects of their engagement, such as rapid interaction and communication. Further empirical studies, however, should aim to measure social media's effects on nursing students' engagement with their courses and their academic attainment.

Feasibility and acceptability of an education and training e-resource to support the sexuality, intimacy and relationship needs of older care home residents: a mixed methods study.

BACKGROUND: sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. OBJECTIVE: to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. METHODS: we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. RESULTS: fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. CONCLUSIONS: the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.

A scoping review of education and training resources supporting care home staff in facilitating residents' sexuality, intimacy and relational needs.

BACKGROUND: Having positive intimate, sexual and relational experiences is an important issue for older adults in care settings, yet little is known on the extent to which nursing staff and care workers have received education or training in addressing and meeting these needs among older residents. This scoping review aimed to identify and examine what education and training resources exist to assist nursing staff and care workers to meet their residents' needs in this area. METHODS AND ANALYSIS: Using the Arksey and O'Malley framework, we systematically searched papers and grey literature to identify education interventions and resources that aimed to facilitate care home staff to meet their residents' sexuality, intimacy and relational needs. RESULTS: Eleven studies (one dissertation) and three education resources met the inclusion criteria; most were conducted in the USA and Australia. Across the studies and resources identified, the education content was mixed and the methodology, presentation, design and duration varied widely. The focus of the education interventions and resources was to increase knowledge and improve and/or change attitudes towards the: (i) sexual expression of older people living in residential aged care, (ii) sexuality and ageing and (iii) expression of sexuality in people with dementia. CONCLUSION: Few education interventions and training resources were identified. The findings suggest that education interventions can improve knowledge and/or change care staff attitudes, in the short-term, towards older people's sexuality, intimacy and relational needs in care home settings, which can lead to facilitating staff to enhance person-centred care in this area of need.

Personality disorder co-morbidity in primary care 'Improving Access to Psychological Therapy' (IAPT) services: a qualitative study exploring patient perspectives on treatment experience.

BACKGROUND: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care 'Improving Access to Psychological Therapies' (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. AIMS: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the 'Standardised Assessment of Personality - Abbreviated Scale' (SAPAS) in receipt of primary care-based IAPT treatment. METHOD: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. RESULTS: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. CONCLUSIONS: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Rapid tranquillisation: an issue for all nurses in acute care settings.

The management of challenging behaviour, violence and aggression is not only an issue for mental health and learning disability nurses. Increasingly, nurses working in emergency departments (EDs), medical assessment units and general medical or surgical wards may encounter acts of challenging behaviour, violence and aggression on a regular basis. Restraint is sometimes used as a tool in the management of these patients; this may be in the form of physical, mechanical or chemical restraint. Rapid tranquillisation (RT) is often considered a form of chemical restraint, which may be used in an emergency situation when prescribed. If RT is given it should be done so as the least restrictive option, with intramuscular and intravenous administration as a last resort. Patient monitoring following administration is paramount. This article explores best practice in the administration of RT from a clinical perspective.

Personality disorder co-morbidity in primary care 'Improving Access to Psychological Therapy' services: A qualitative study exploring professionals' perspectives of working with this patient group.

A high prevalence of people present to 'Improving Access to Psychological Therapies' (IAPT) in England with common mental health disorders and co-morbid personality disorder. This group have suboptimal treatment outcomes in IAPT. Whilst new short-term treatment approaches are advocated, no solutions or guidance have been provided. This qualitative study explored IAPT health-care professional (N = 28) perspectives of working with people who present to IAPT with co-morbid personality disorder. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analysed using a framework analysis approach. Results identified a lack of skills and confidence in working with this patient group, restrictive service constraints and a treatment gap between the interface of primary and secondary services. Insight into acceptable adaptions to practice are identified that have transferable utility to a wider international audience who can identify people outside of specialist mental health services with common mental health disorders and co-morbid personality disorder traits. © 2019 John Wiley & Sons, Ltd.

Openness, inclusion and transparency in the practice of public involvement in research: A reflective exercise to develop best practice recommendations.

CONTEXT: Reflective accounts of public involvement in research (PI) are important for helping researchers plan and deliver more effective PI activities. In particular, there is a need to address power differentials between team members that can prohibit effective and meaningful involvement. OBJECTIVE: To critically reflect on the PI practices that underpinned our research project on intimacy and sexuality in care homes, to develop a series of recommendations for improving future PI activities. SETTING: The research team comprised five academics from nursing, public health, sociology and psychology, and two members of the public with experience of sex education, and lesbian, gay, bisexual and trans issues in older populations. In order to address power differentials within the group, we developed an approach to PI practice that was grounded in values of openness, inclusion and transparency. METHOD: Reflective commentaries on the strengths and weaknesses of the team's approach to PI were gathered through interviews and open-ended questionnaires with research team members. These views were collated and discussed at a workshop comprising research team members and an additional member of the public to generate recommendations for future PI practice. RESULTS: A number of strengths and limitations of our approach to PI were identified. Clear recommendations for improving PI practice were developed for three broad areas of identified difficulty: (i) communication within and between meetings; (ii) the roles and responsibilities of team members; and (iii) PI resources and productivity. DISCUSSION AND CONCLUSION: These recommendations add to the developing body of guidance for conducting effective PI.

Old(er) care home residents and sexual/intimate citizenship.

Sexuality and intimacy in care homes for older people are overshadowed by concern with prolonging physical and/or psychological autonomy. When sexuality and intimacy have been addressed in scholarship, this can reflect a sexological focus concerned with how to continue sexual activity with reduced capacity. We review the (Anglophone) academic and practitioner literatures bearing on sexuality and intimacy in relation to older care home residents (though much of this applies to older people generally). We highlight how ageism (or ageist erotophobia), which defines older people as post-sexual, restricts opportunities for the expression of sexuality and intimacy. In doing so, we draw attention to more critical writing that recognises constraints on sexuality and intimacy and indicates solutions to some of the problems identified. We also highlight problems faced by lesbian, gay, bisexual and trans (LGB&T) residents who are doubly excluded from sexual/intimate citizenship because of ageism combined with the heterosexual assumption. Older LGB&T residents/individuals can feel obliged to deny or disguise their identity. We conclude by outlining an agenda for research based on more sociologically informed practitioner-led work.

The challenges and opportunities in researching intimacy and sexuality in care homes accommodating older people: a feasibility study.

AIM: To explore the challenges of conducting research on sexuality and intimacy among older care home residents. BACKGROUND: Sexuality and intimacy are neglected in care policies and practices. DESIGN: Qualitative analytical study drawing on poststructuralist theorizing. METHODS: Semi-structured interviews were conducted with residents and spouses (n = 6) and care staff (n = 16) in two care homes in Northwest England in 2014. The sample was obtained through a network of 'research-ready' care homes. Thematic analysis was used to make sense of narratives with the aid of NVivo10. RESULTS: Participant responses highlight the workings of ageist erotophobic discourse that undergirds the assumption of residents (and old people generally) as postsexual. This materialized in reservations about the research ranging from opposition on moral grounds to doubts about its feasibility given the age-group concerned. However, residents and care home staff can also draw on counter-discourses that resist/challenge ageist erotophobic thinking, which materialized in methodological and ethical recommendations. CONCLUSION: Participants generally agreed with the principle of the research and made recommendations that could counter/resist ageist erotophobic governance and guide researchers on sampling, style of questioning and communicating with (prospective) study participants on a sensitive subject.

Sexuality and intimacy among care home residents.

Discussing sexuality and intimacy with older people can be problematic, so it is not uncommon that their needs go unrecognised. This article identifies barriers to addressing sexuality and intimacy needs, and outlines some simple strategies to raise awareness of them among older care home residents and staff, thereby facilitating a discussion to enable such needs to be met.

Nurses and subordination: a historical study of mental nurses' perceptions on administering aversion therapy for 'sexual deviations'.

This study aimed to examine the meanings that nurses attached to the 'treatments' administered to cure 'sexual deviation' (SD) in the UK, 1935-1974. In the UK, homosexuality was considered a classifiable mental illness that could be 'cured' until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of their SD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered 'acceptable practice'.

'Queer' treatments: giving a voice to former patients who received treatments for their 'sexual deviations'.

AIMS AND OBJECTIVES: The study aimed to examine the experiences of patients and meanings attached to 'treatments' of sexual deviations, which included homosexuality and transvestism, in the UK (1949-1992), exploring reasons for such treatments, experiences and how individual lives were affected. BACKGROUND: Male homosexuality remained illegal in England until 1967 and, along with transvestism, was considered an antisocial sexual deviation that could be cured. Homosexuality remained classifiable as a mental illness until 1992. Nurses were involved in administering treatments to cure these individuals; however, there is a paucity of information about this now-discredited mental health nursing practice. DESIGN: A nationwide study based on oral history interviews. METHODS: Purposeful and snowball sampling was utilised when selecting participants for the study. Participants were recruited via adverts in gay establishments/media. All participants gave signed informed consent. Face-to-face oral history interviews were conducted and transcribed for historical interpretation. RESULTS: Seven former male patients made contact, aged 65-97 years at interview. All reported that the treatments had been unsuccessful in altering their sexual desires or behaviour. Most sought treatment owing to unsupportive and negative attitudes from friends, family and wider society. Others selected treatments instead of imprisonment. Most eventually found happiness in same-sex relationships. However, all were left feeling emotionally troubled by the treatments they received. CONCLUSION: Defining homosexuality and transvestism as mental illnesses and implementing what could be argued to be inefficient treatments to eradicate them appears to have had a lasting negative impact on the patients who received them. RELEVANCE TO CLINICAL PRACTICE: Nurses who care for older gay, lesbian, bisexual and transgender patients need to be mindful of their potential past treatment by healthcare services and ensure that they are non-judgmental and accepting of their sexual orientation and current gender.

Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm.

AIMS: This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. BACKGROUND: Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. METHODS: Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. RESULTS: Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. CONCLUSIONS: Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development.

Managing aggression and violence using rapid tranquillisation.

Aggression and violence sometimes occur in mental health settings, and nurses need to know how to de-escalate these situations. If de-escalation techniques are unsuccessful, the patient may need to be physically restrained or placed in seclusion. It may also be necessary to administer medication to calm the individual. This article explores the nurse's role in relation to the use of rapid tranquillisation as part of the management of aggression and violence. The procedure is outlined and the importance of patient monitoring to observe for possible adverse effects is discussed. The legal and ethical issues are examined, along with guidance on the use of advance directives.

Stress and burnout in forensic mental health nursing: a literature review.

Forensic mental health nurses who work with patients who have severe and enduring mental health needs have been identified as at risk of suffering from occupational stress, and even developing burnout syndrome. Therefore, this article reviews the available literature on stress and burnout in inpatient forensic mental health nursing to identify the stressors and to highlight recommendations. From the review, the main stressors placed on forensic nurses are identified as interprofessional conflicts, workload, and lack of involvement in decision-making. Recommendations to reduce stress and burnout for nurses within this specialty are highlighted. These are identified as follows: staff should have easy access to support systems including clinical supervision; managers should foster an open and honest culture to enable staff members to express their feelings openly or in confidence and learn how to deal with their frustrations; and staff should be encouraged to rotate wards to increase personal and professional development and reduce boredom and apathy. Furthermore, staff should be provided with, and encouraged to undertake, continuing professional development which may include psychosocial interventions training.

Section 5(4) of the Mental Health Act 1983: the art of applying the Act.

Section 5(4) of the Mental Health Act 1983 allows patients to be detained by nurses of the 'prescribed class' for a maximum of 6 hours. There is a paucity of research on the subject of Section 5(4); however, the little research that has been conducted has shown that there are gaps in the knowledge of registered nurses and nursing students due to be registered with regard to the following areas of Section 5(4): duration of the holding power; whether the client can be treated against their will; eligibility for detention; and criteria for implementation. This article will seek to clarify these gaps and provide nurses with a comprehensive systematic guide to follow should they have to invoke the section.