Journal of the American Psychiatric Nurses Association

Serious mental illness (SMI) in pregnancy is a public health concern due to associated poor maternal-child outcomes. There is a gap in the literature about the healthcare experiences of pregnant women with SMI and the experiences of providers who care for this population. The purpose of this scoping review is to examine the current state of the science regarding the experiences of pregnant women with SMI and the experiences of providers when treating this population.

The aim of this review was to fill a knowledge gap that is needed to facilitate paradigm shifts in the treatment of pregnant women with SMI.

We conducted a systematic search for published, peer-reviewed, English-language literature addressing the experiences of pregnant women with SMI receiving care and the experiences of those providing care to the population. The databases searched were OVID MEDLINE, Embase (OVID), CINAHL, PsycINFO (EBSCO), and Sociological Abstracts (ProQuest).

Sixteen qualitative and mixed-method articles focused on pregnant women with SMI were included in this review. Key themes emerged regarding patients’ desire for specialized providers for treatment, preparedness in pregnancy, access to quality guidance and information, special attention to issues/concerns, guidance in medication, and care integration. Providers reported a desire for better interdisciplinary communication and specialized knowledge and expertise regarding SMI.

This review provides insight into areas where interprofessional collaboration can be vital in helping improve health outcomes; however, more research is needed surrounding the perspectives of providers and their support and resources when treating this population.

About 115,000 young people in the United States experience a first episode of psychosis (FEP) annually. FEP is associated with functional decline and long-term executive functioning impairment. Schizophrenia is a risk factor for homelessness with up to 20% of individuals diagnosed experiencing homelessness. Homelessness conveys many burdens including higher rates of victimization, incarceration, and substance use. The intersection of homelessness and FEP represents a uniquely vulnerable population undergoing the compounding effects of two highly stigmatizing burdensome experiences that negatively impact health outcomes, treatment engagement, and life expectancy.

This study reviews the literature to explore what is currently known about the impacts of homelessness on individuals with FEP, knowledge gaps, directions for research, and recommendations for action.

An integrative review was conducted in April 2023 with APAPsychInfo, APAPsychArticle, Medline, and CINAHL.

This is the first known review to examine available literature on homelessness and FEP. Current literature examines aspects of FEP and homelessness, but not the likely compounding and interacting relationships between multiple variables. Although the associations among variables such as FEP, homelessness, substance use, legal involvement, family involvement, and treatment engagement have not been studied, the literature available may be suggestive of a compounding negative effect on FEP outcomes.

FEP programs should define homelessness, report rates of homelessness, and conduct research examining the compounding effects of homelessness and FEP as well as other factors like race and ethnicity. Research and policy should support housing interventions for homeless individuals to improve treatment engagement and health outcomes.

One of the most crucial objectives in the education and treatment of young children with autism spectrum disorder (ASD) is independence in daily living skills (DLS). Therefore, as a child with ASD condition grows, measures of everyday functioning including adaptive behaviors should be more regularly monitored and regulated.

The primary aim of this study was to evaluate the feasibility of a developed theory-based training program and its preliminary effectiveness on the acquisition of DLS among school-age children with ASD.

A preliminary experimental research design (pre- and post-evaluation) was conducted from the beginning of May to the end of July 2023 on 31 children with ASD. The socio-economic status scale, Vineland Adaptive Behavior Scale, and Gilliam Autism Rating Scale were administered before and after a theory-based DLS training program.

There was a significant difference in the DLS and motor functioning before and after the implementation of the training program (p < .001 and p = .021, respectively). In addition, there was a significant difference in the total score of autistic severity before and after the implementation of the training program (p < .001).

The promising outcomes of the study indicate the need for further testing and expansion of this intervention. These findings contribute to the growing body of evidence highlighting the significance of DLS training program in the comprehensive treatment approach for children with ASD. Consequently, proposing DLS training programs as a cost-effective and efficient nursing intervention is warranted.

Nursing presence is a core relational phenomenon in nursing. It is the process of devoting attention to being with and connecting with another, requisite to providing quality, holistic, person-centered care. Presence has been incorporated in the newly revised scope and standards of nursing, as an intervention. There is a paucity of research on the experience of nurses practicing in mental health settings who employ presence to provide unique, relational care.

The aim of this research is to understand the lived experience of nurses providing nursing care and engaging with presence in the mental health setting.

The tenets of hermeneutic phenomenology proposed by Heidegger and Gadamer were used to guide this inquiry. Twelve nurses practicing mental health were interviewed on Zoom using a semistructured interview guide and the interview time ranged from 45 min to 1 hr. Data were analyzed using the interpretative phenomenological analysis (IPA) process outlined by Smith et al.

Four themes are identified: A powerful intervention which fuels healing, Building the bridge, Transcending barriers, and Preserving the well.

Nursing presence is implicated as essential to improving the quality of holistic health care, positively impacting patients and nurses. These findings may influence nursing leaders, educators, and administrators to incorporate nursing presence in nursing curricula, develop policies respecting presence, and alter the culture of the health care environment.

Earthquakes cause significant psychological and physical trauma in children, especially when leading to amputations, as they disrupt physical, emotional, and social well-being.

This study was conducted phenomenologically to explore the experiences of children amputated in the Kahramanmaraş earthquake and their parents/caregivers.

This study was conducted as a phenomenological study with children who were amputated in the Kahramanmaraş earthquake and their parents/caregivers between August and October 2023. The sample of the study consisted of seven children and their parents/caregivers who met the inclusion criteria and volunteered to participate in the study through purposive sampling method. Data were collected through in-depth interviews using an introductory information form and a semistructured interview form developed by the researcher.

It was found that 57.2% of the children who participated in our study were male and their mean age was 11.25 ± 4.02 years. It was found that all the children’s houses were destroyed in the earthquake, they were trapped under the debris, and they experienced losses in their family members and relatives. As a result of data analysis, nine themes were identified as apocalypse, pain, fear, and hopelessness for children and apocalypse, helplessness, pain, anger, and hopelessness for parents/caregivers.

This study found that earthquake-affected amputee children perceived the earthquake as an apocalypse, experienced prolonged pain during hospitalization, continued to fear the earthquake, and felt hopeless about the future. The children’s parents/caregivers also reported that they perceived the earthquake as an apocalypse, that they felt helpless and hopeless for themselves and the children, and that the children had angry/irritable behavior with pain after the disaster.

Depression is a growing concern among university students. Chatbots provide flexible, accessible, personalized psychosocial support. Delivering Mindfulness-Based Stress Reduction (MBSR) sessions via chatbots may reduce depressive symptoms in university students.

This study aims to evaluate the feasibility, acceptability, safety, and preliminary efficacy of a chatbot-based MBSR intervention for university students with depressive symptoms.

A rule-based MBSR chatbot was developed and evaluated with a single-group pretest–posttest study for university students in Hong Kong (N = 30) reporting depressive symptoms, followed by the collection of their subjective feedback. The intervention lasted eight weeks. The primary clinical outcome was depression levels, with a range of secondary outcomes.

The chatbot-based MBSR program demonstrated satisfying recruitment, retention, and adherence rates. The safety of the program was confirmed by the absence of any adverse events directly related to the intervention, tracked from the onset of the intervention to the completion of data assessment. Significant improvements were observed in both primary and secondary outcomes. Participant feedback highlighted the benefits of the program and its effects on depressive symptoms.

The program has shown feasibility, acceptability, safety, and preliminary efficacy in reducing depressive symptoms among 30 university students in Hong Kong. The intervention should now be evaluated in a randomized controlled trial with follow-up. This study highlights the potential role of chatbot-based interventions in mental health promotion, nursing, and clinical practice and will inform the subsequent development of innovative digital interventions to address mental health challenges faced by university students.

Studies have found that trait mindfulness is associated with lower levels of depressive symptoms among people diagnosed with schizophrenia. Still, the role of the perceived public stigma in this association has yet to be established.

The purpose of this study was to assess the association between mindfulness and depressive symptoms experienced by people diagnosed with schizophrenia, controlling for the impact of their demographics and their perceived public stigma against mental illness.

A quantitative descriptive correlational design was used. The sample included 184 Jordanian outpatients diagnosed with schizophrenia who completed self-administered measures of mindfulness, depressive symptoms, public stigma against mental illness, and demographic information. Multiple hierarchical regression analysis was performed to identify the unique variance in perceived depression explained by participants’ demographic and clinical variables, public stigma, and mindfulness.

Participants had moderate perceived discrimination and moderate to severe depression. Age, gender, perceived physical pain, perceived public stigma, and mindfulness were significantly correlated with depression among the study participants. After controlling for demographic and clinical variables, public stigma was significantly associated with depression and accounted for 14% additional variance above and beyond the 37% accounted for by demographic and clinical variables. Mindfulness accounted for a 15% additional variance above and beyond the variance accounted for by all other predictors.

Anti-stigma programs could be combined with mindfulness-based interventions to reduce depression in people diagnosed with schizophrenia.

In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice.

Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice.

Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances.

Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.