Empowerment of individuals with enduring mental health problems: results from concept analyses and qualitative investigations.

Empowerment has been proposed to enhance the well-being of individuals with enduring mental health problems. Despite this apparent endorsement, critics charge that the concept of empowerment is poorly defined, and its actualization within mental health care is rare. Concept analyses and findings from qualitative research offer helpful insights into the process of empowerment and ways to promote it among individuals with long-term mental health problems. An empowerment model is proposed based on concept analyses, which are supported by qualitative findings.

Serotonin syndrome and the use of SSRIs.

Nurses need to become more aware of serotonin syndrome to avoid its development and to ensure a therapeutic response when early symptoms emerge. While polypharmacy tends to put individuals at greatest risk for the syndrome, use of a single serotonergic agent may also provoke an adverse response. Because the onset and progression of serotonin syndrome are rapid, prompt action may be needed to avoid potentially life-threatening consequences.

Metasynthesis: the state of the art--so far.

To make qualitative results more accessible to clinicians, researchers, and policy makers, individuals are urged to synthesize findings from related studies. Since 1994, several types of metasynthesis have been conducted, resulting in theory building, theory explication, and substantive descriptions of phenomena. A variety of methodologies have been used to complete these projects, as no firm metasynthesis guidelines exist. As such, the purpose of this article is to discuss recently completed works and draw inferences regarding key methodological elements and research study integrity. The author also offers suggestions for future investigations.

Health belief model and reversal theory: a comparative analysis.

BACKGROUND: In recent years, an increasing number of nurses have demonstrated interest in health behaviour change interventions and research. Despite this heightened enthusiasm, there appears to have been less interest in exploring new and emerging health behaviour change theories. AIM: The goal of this work is to assist clinicians and researchers to make more informed choices about the use of the Health Belief Model and Reversal Theory in their practice settings and research projects. METHOD: Primary sources were analysed using qualitative data analysis methods in order to compare and contrast the two models. Four comparative categories provided the structure for analysis: origins of models, ways of knowing and behaving, role of health care providers in behaviour change, and desired outcomes. RESULTS: Based, in part, on their historical origins, the Health Belief Model and Reversal Theory offer differing tenets regarding how individuals perceive, understand, and behave. According to Reversal Theory, ways of knowing and behaving are dependent upon innate physiological factors and subjectively structured perceptions. In contrast, the Health Belief Model suggests that health-related behaviours are largely attributable to cognitive decision-making processes. As such, health care providers are directed to approach health behaviour change in different ways. CONCLUSIONS: Although the Health Belief Model has been widely implemented, Reversal Theory may offer a more comprehensive framework for health behaviour change interventions and research. Clinicians and researchers are urged to learn more about this theory and how it may apply to their areas of practice and research.

Selective serotonin reuptake inhibitor. Discontinuation syndrome.

Based on emerging research findings, nurses are urged to become more aware of SSRI discontinuation syndrome. To ameliorate or avoid the associated symptoms, client education is recommended, and dosage tapering is encouraged whenever possible. Although the symptoms associated with discontinuation syndrome usually are mild, they may pose particular safety concerns for clients with co-occurring conditions. In these situations, precautions should be taken to prevent exacerbation of existing problems.

Selective serotonin reuptake inhibitors and treatment of premenstrual dysphoric disorder.

TOPIC: Premenstrual dysphoric disorder (PMDD) has reentered the spotlight following the FDA's recent approval of fluoxetine hydrochloride to treat its symptoms. Although the diagnosis and treatment of PMDD has long been a source of contention, the FDA move has heightened the debate over this diagnostic category and the most appropriate treatment. PURPOSE: To explore several diagnoses related to PMDD and review recent research findings pertaining to the effectiveness of SSRIs to treat PMDD. SOURCES OF INFORMATION: Published literature. CONCLUSIONS: Advanced practice nurses need to remain well informed about premenstrual conditions and emerging evidence-based treatment alternatives. In particular, they need to remember that the FDA has approved fluoxetine for the treatment of a very small subset of women with premenstrual complaints, among whom treatment efficacy is limited.

Anorexia nervosa: analysis of long-term outcomes and clinical implications.

Recovery from anorexia nervosa is a lengthy process and involves overcoming physical as well as psychosocial problems. Factors such as weight at referral, laboratory values, and psychosocial variables tend to predict long-term outcomes and help guide clinical interventions. Non-weight restored as well as some weight restored individuals experience chronic problems. Long-term consequences of anorexia nervosa indicate a need for continued oversight and individual treatment planning.

Feminist spirituality and alcohol treatment.

Although there is some evidence that spirituality may play a role in successful resolution of alcohol problems, there are those who assert that traditional androcentric theologies may be detrimental to the healing process among women. Within conventional religious traditions, women have been relegated to positions of diminished status and power and may be subject to expectations of self-abnegation. For these reasons, asserting powerlessness and abdicating control to a male-defined deity may be nontherapeutic. In contrast, feminist spirituality represents a collage of traditions that enable women to identify the divine within and find strength and power through their interpersonal relationships and lived experiences. Together, the foci of feminist spirituality and women's health care provide new perspectives for alcohol treatment. Nurses need to become aware of these viewpoints and ways in which they can be integrated into their practices.

Self-resolution of alcohol problems in young adulthood: a process of securing solid ground.

Quantitative research findings suggest that young adults resolve alcohol problems without participating in support groups or formal treatment programs. However, researchers have failed to fully explain the self-resolution process among this age group. Thus, the authors used grounded theory to better explicate why and how young adults self-resolve alcohol problems. The findings suggest that self-resolving alcohol problems in young adulthood involves a temporal process of seeking and securing solid ground. This process is precipitated by situations in which individuals experience precarious footing and eventually begin to lose their balance. These culminating events lead young adults to pursue personal visions and find safe footing on solid ground, despite some rugged terrain along the way.