Current knowledge and attitudes of psychiatric nurses toward electroconvulsive therapy.

PURPOSE: This study assessed the current knowledge and attitudes of psychiatric nurses toward electroconvulsive therapy (ECT). DESIGN AND METHODS: A quantitative, nonexperimental study was conducted at a large psychiatric hospital in the United States. The Questionnaire on Attitudes and Knowledge (QuAKE) Scale was used to conduct the assessment among a convenient sample of 158 psychiatric nurses. FINDINGS: Participants' responses to questions that elicited knowledge of ECT ranged from 45% to 99% and positive attitudes ranged from 21% to 96%, revealing increased levels when compared with the low to average knowledge and positive attitudes noted in previous studies. PRACTICE IMPLICATIONS: Targeted ECT education is needed among psychiatric nurses with limited knowledge and negative attitudes toward ECT.

Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States.

INTRODUCTION: Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. PURPOSE: To explore MHS perspectives of assault by psychiatric patients. METHODS: A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants' age ranged from 22 to 63 years (mean age = 32.4). Moustakas' theoretical underpinnings guided the study. RESULTS: Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes-increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes-unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. DISCUSSION: Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient's behavior. CONCLUSION: The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

Psychosocial Impacts of Immigration on Nigerian Immigrants in the United States: A Phenomenological Study.

Introduction. Nigerian immigrants constitute a major proportion of the increasing immigration trend from sub-Saharan Africa to the United States. However, limited studies exist on the psychosocial impacts of their immigration experiences. This phenomenological study, based on Husserlian philosophy, explored the perceptions of Nigerian immigrants about the psychosocial impacts of immigration to the United States. Method. Twenty Nigerian immigrants in Houston, Texas, constituting a purposive sample were interviewed face-to-face using semistructured guided questions and probes. Results. A thematic analysis using Giorgi's approach revealed both positive and negative themes but mostly negative psychosocial experiences of migration to the United States. Discussion. The participants associated the most negative experiences with the lack of adequate preparation prior to migration and the cultural differences between the two countries. Notwithstanding that the findings of this study have health and immigration policy implications and increased awareness for potential immigrants, further studies are needed.

Depression and Perspectives of Nigerian Immigrant Men in the United States: An Applied Ethnographic Study.

INTRODUCTION: Depression is among the most serious health problems experienced by immigrants. Research has not sufficiently explored the perspectives of immigrant men from male-dominant cultures on depression. The purpose of this study was to describe the perspectives of Nigerian immigrant men in the United States on depression and to determine whether their perceptions differ from those of their female counterparts of a previous study. METHOD: Focused applied ethnography was used to explore the perspectives of a purposeful sample of 18 Nigerian immigrant men in Houston, Texas, and analyze the data using a thematic approach. RESULTS: The overarching theme was, "Depression does not exist in the Nigerian culture." The participants denied the existence of depression. Gender differences were not noted in their perception of depression. DISCUSSION: The participants perceived depression differently from the U.S. dominant culture and may not receive adequate screening or treatment for depression, supporting the extant call for recognition of cultural differences in health care.

Knowledge and Attitude Towards Pharmacological Management of Acute Agitation: A Survey of Psychiatrists, Psychiatry Residents, and Psychiatric Nurses.

OBJECTIVE: The authors compared the current knowledge and attitude of psychiatrists, psychiatry residents, and psychiatric nurses towards the pharmacological management of acute agitation. METHODS: Questionnaires were electronically distributed to all attending psychiatrists, psychiatry residents, and psychiatric nurses who were either employed by the University Department of Psychiatry and Behavioral Sciences or were staff at a 250-bed affiliated Psychiatric Hospital. Where possible, Fisher's exact test was used to compare responses to questions based on designation. RESULTS: Of the 250 questionnaires distributed, 112 were returned (response rate of 44.8%), of which 64 (57.1%) were psychiatric nurses, 27 (24.1%) were attending psychiatrists, and 21 (18.8%) were psychiatry residents. A significantly higher percentage of attending psychiatrists and psychiatric nurses compared to psychiatry residents thought that newer second- generation antipsychotics (SGAs) are not as effective as older first-generation antipsychotics (FGAs) for managing acute agitation (55.6, 48.4, and 9.5% respectively, p = 0.008). The combination of intramuscular haloperidol, lorazepam, and diphenhydramine was the most preferred option chosen by all designations for the psychopharmacological management of severe agitation. Furthermore, a larger percentage of the psychiatric nurses, in comparison to attending psychiatrists, also chose the combination of intramuscular chlorpromazine, lorazepam, and diphenhydramine as an option for managing severe agitation; no psychiatry resident chose this option. CONCLUSION: Knowledge of evidence-based psychopharmacological management of agitation differs among attending psychiatrists, psychiatry residents and psychiatric nurses. Although the management of agitation should be individualized and context specific, monotherapy should be considered first where applicable.