Nurses' views on the provision of physical healthcare for individuals with comorbid mental illness and chronic disease.

The prevalence of chronic diseases (such as diabetes, obesity, cancer, heart disease, and chronic obstructive pulmonary disease) continues to increase among patients with mental illness. This cross-sectional study investigated the factors affecting nurses' views on the provision of physical healthcare to patients with comorbid mental illness and chronic disease. In total, 369 nurses working in mental health were assessed for the physical healthcare attitudes and practices using the Physical Health Attitude Scale for Mental Health Nurses. The results of generalized linear modelling indicated that nurses' involvement in physical healthcare was associated with psychiatric mental health nurse credentials (B = 1.560, 95% CI = 0.292-2.828, P = 0.016) and their confidence in delivering physical healthcare was associated with prior physical healthcare training (B = 0.639, 95% CI = 0.104-1.174, P = 0.019). In addition, the frequency with which the nurses engaged in physical healthcare practices was associated with working in a community unit (B = -7.416, 95% CI = -9.652 to -5.180, P < 0.001), involvement in physical healthcare (B = 0.349, 95% CI = 0.162-0.535, P < 0.001), and confidence in delivering physical healthcare (B = 1.148, 95% CI = 0.776-1.519, P < 0.001). Our findings suggest that interventions aiming to help nurses assess and improve their own physical healthcare practices should consider nurses' background and patients' physical health needs in various settings and focus on cultivating an organizational culture that gives nurses confidence in providing physical healthcare.

Correlations between Psychiatric Symptoms and Quality of Life in Patients with Psychological Disorders: Hospital-Based Retrospective Study.

Little research has been conducted on the relationship between the five-item Brief Symptom Rating Scale (BSRS-5) and quality of life in patients with mood disorders. The purpose of this study was to investigate potential effects of psychological symptoms on quality of life in patients with psychological disorders. We recruited 124 patients with psychological disorders from a psychological teaching hospital in northern Taiwan. Data were obtained from medical records of all patients with a diagnosis of mood or adjustment disorder. We assessed psychological symptoms on the BSRS-5 and examined quality of life by using the Taiwanese version of the abbreviated World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). We performed hierarchical linear regression analysis to explore the relationship between psychological symptoms and quality of life. The analysis revealed a significant correlation between the items on the BSRS-5 and WHOQOL and their correlations with the total scores on these assessments (p < 0.01 and p < 0.05). Our findings indicated that scores on the BSRS-5 can predict scores on quality of life. This suggests that psychometrically measured psychological symptoms constitute critical determinants of quality of life.

Facing death, facing self: nursing students' emotional reactions during an experiential workshop on life-and-death issues.

AIM AND OBJECTIVES: This study presents the findings of a qualitative study exploring the experiences of undergraduate nursing students imagining the possibility of their own death during a workshop on life-and-death issues. BACKGROUND: Didactic instruction in end-of-life care is a critical element of nursing education and for most health professions training in general. Properly implementing this often-overlooked educational process requires providing students with opportunities to reflect on death and dying along with guidance during nursing practice in coping with emotional reactions to caring for dying patients. DESIGN: An interpretive descriptive design was adopted. METHOD: Data were gathered from the text of 20 students' reflective journals and workshop evaluations and researchers' field notes on observations during the workshop at a Taiwan university in August 2007. RESULTS: Students experienced a process of dying, death and rebirth. Students not only expressed emotional responses that included surprise, reluctance to let go and gratitude but also realised the importance of cherishing the present, committing to the nursing profession and valuing their own lives. CONCLUSIONS: Students can learn their fear of death and possible emotional reactions towards dying patients through self-reflection during a workshop on life-and-death issues. The foundation for facilitating students' self-awareness is a safe environment for them to gain experiential knowledge of the dying process and end-of-life care. Experiential education not only helps students grow personally but also increases their motivation to learn. RELEVANCE TO CLINICAL PRACTICE: Students' ability to recognise and manage their own emotional reactions towards death and dying patients should be included as part of end-of-life education. A workshop on life-and-death issues can help students discover that they are not alone and that they can support each other and learn how to manage their own emotions.

A moral life after a suicide death in Taiwan.

In this article we present the findings of a qualitative study exploring what suicide survivors in Taiwan experienced after a family member's suicide and how they adjusted to the perceived stigma. Fifteen suicide survivors participated in this study. We found that when a family member's suicide death occurred, survivors first kept a low profile when holding the funeral, and then tried to expel the dead person from their family. They also wished that their grief and painful, shameful feelings could be buried with the dead person. These findings suggest that health care professionals need to work more closely with suicide survivors through understanding the survivors' fear and pain from a sociocultural perspective, and to help them construct a new moral life.

The invisible family: a qualitative study of suicide survivors in Taiwan.

The purpose of this interpretive phenomenological study is to describe the commonality of the lived experience of suicide survivors and how it influences their family relationships in Taiwan from a sociocultural perspective. Thirteen suicide survivors have participated in this study. Study results reveal that some survivors blame themselves, some blame others, and some are blamed by their family as part of their need to find a reason for the death. Consequently, family members ignore each other and treat each other as if they are invisible. These Chinese suicide survivors, unlike Western survivors, maintain their strained family connections because of strong cultural influences. Therefore, health professionals should acknowledge the experiences of living with an invisible family when supporting Chinese suicide survivors.