The Revista de Enfermería y Salud Mental is a scientific journal published by Editorial Glosa, S.L. Its aim is to disseminate research and other scientific content that contributes to the development of knowledge and care in the field of mental health. The journal addresses current topics of interest to nursing professionals, promotes evidence-based care, supports the integration of research into clinical practice, and provides information for professional development and continuing education. Although primarily intended for the nursing community, its content may also be relevant to other professionals involved in health sciences and mental health care, including social workers, psychologists and psychiatrists. The journal is published in Spanish every four months—three regular issues per year: January–April, May–August and September–December—and assigns DOIs to its articles.
1st Poster Competition «Measuring Health Outcomes». 2020 Awards
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Psychoeducational group for the promotion of physical activity in a psychiatric treatment and rehabilitation hospital unit
Introduction. The high prevalence of sedentary behaviour among people with severe mental disorder obliges healthcare professionals to adopt measures aimed at modifying sedentary behaviour and enhancing physical activity, whose benefits on health are sufficiently demonstrated, in the face of the negative impact of sedentary behaviour as a risk factor for morbidity and mortality. The WHO advises improving the physical health status of these patients through promotion and prevention measures, including specific psychoeducational programmes. Objectives. To foster the implementation of a healthy lifestyle, modify sedentary behaviour and enhance physical activity. Methodology. Using the NANDA, NOC and NIC taxonomies as a reference framework, a psychoeducational workshop of 16 sessions of 80 minutes each is proposed. Evaluation. By means of a five-point Likert scale applied to the indicators of the selected NOC outcome criterion, two measurements will be obtained, baseline and post-intervention; likewise, the workshop will be evaluated with an observer’s guide and a satisfaction survey.
The National and European Mental Health Strategy and the World Health Organization promote the improvement of the physical health status of patients with mental illness and the use of preventive and health-promotion measures as a routine part of their approach. With the aim of improving the quality of life of people with severe mental disorder and reducing the impact of treatments on the appearance of metabolic syndrome, this project aims to assess the effectiveness of exposure to psychoeducational messages on healthy lifestyles right from admission to an acute unit, a period during which the patient benefits from continuous monitoring by the nursing team. As validation instruments, the record of physical and laboratory parameters, an ad hoc survey on lifestyle and the SF-36 health questionnaire will be used at admission and discharge. Follow-up of patients will be carried out at 3 and 6 months after discharge.
Nursing programme for metabolic control and quality of life in an outpatient population on antipsychotic treatment
Patients with severe mental disorder, schizophrenia or other psychotic disorders are the main users of the mental health nursing clinic and have poorer physical health than the general population. The objectives of this project are to assess quality of life, physical health and the presence of metabolic syndrome in outpatients on antipsychotic treatment and to identify the favourable changes achieved after working for one year on two nursing diagnoses of the NANDA taxonomy: Imbalanced nutrition: more than body requirements and Sedentary lifestyle. A descriptive cross-sectional study is proposed at baseline, with anthropometric measurements (weight, body mass index, abdominal perimeter), blood pressure measurement and blood tests, with quality of life measured using the Global Assessment of Functioning scale and the Spanish version of the EuroQol-5D questionnaire, and a comparative longitudinal study of the initial results with those obtained at one year of follow-up after applying the nursing programme. The sample is made up of patients who come for injectable antipsychotic treatment and sign the informed consent; the scales are applied individually and always by the same qualified nursing professional.
Presentation text of the supplement that brings together the finalist works of the First Best Nursing Project Competition on Quality of Life and Physical Health in Patients with Severe Mental Disorder, organized by the Journal of Nursing and Mental Health. The Scientific Committee contextualizes the burden of mental disorders, the impact of antipsychotic medication and unhealthy habits on physical health, and the value of physical exercise and of nursing health-promotion interventions to normalize metabolic markers and improve quality of life. Of the 39 works submitted, four finalists were selected, presented and defended at the IV Catalan Congress of Mental Health Nursing (Vic, 12-13 May 2016): «Menja i Mou-te», the metabolic control programme in an outpatient population, the psychoeducational group for the promotion of physical activity and the winning project on quality of life and physical health.
Nursing project on quality of life and physical health in patients with severe mental disorder
This nursing project on quality of life and physical health in patients with severe mental disorder is designed to be carried out in medium-stay units, a hospital resource of continuous care and limited stay oriented primarily to covering the needs and rehabilitation of these patients, who require a controlled approach in a structured environment. The main objective is to improve physical health, mental health and cognition and, with this, to increase the quality of life of the admitted patient, through a series of psychoeducational programmes and interventions that make it possible to address their needs by acting mainly on modifiable risk factors. The methodology is organized in successive phases of screening and assessment (anthropometric measurements, laboratory tests and scales of adherence, consumption, quality of life and symptoms), formulation of NANDA nursing diagnoses with NOC objectives and NIC interventions, assignment to health education, weight control, physical activity and activities of daily living workshops, and periodic evaluation with a view to discharge.
Care of the mentally ill person in a prison. Benefits that positive psychology could bring to their treatment, rehabilitation and reintegration
The constitutional purpose of custodial sentences is the re-education and social reintegration of the convicted person. In this framework, this work presents the Framework Programme for Comprehensive Care of the Mentally Ill (PAIEM) in prisons, whose objectives are to detect, diagnose and treat mental disorders, improve the quality of life and autonomy of the inmate and optimize their social reintegration through a multidisciplinary team in which nursing plays an essential role because of its continuous contact with the inmates. The author argues how positive psychology, through concepts such as resilience, the state of flow, creativity and emotional intelligence, can complement the treatment and rehabilitation of the incarcerated mentally ill person, enhancing their strengths, improving behaviour regulation and coping with adversity, and helping to prevent relapses in substance use and destabilizations of the underlying pathology.
Patient with Lewy body dementia: clinical nursing approach
Lewy body dementia (LBD) is a degenerative cognitive syndrome that is difficult to diagnose, characterized by mental deterioration of frontal predominance, parkinsonism, psychotic features and cognitive fluctuations, frequently confused with Alzheimer's or Parkinson's disease. We present the case of a 75-year-old woman admitted to a geriatric residence, approached according to Lynda Carpenito’s bifocal practice model. After nursing assessment by Marjory Gordon’s functional health patterns, a care plan was developed with the NANDA, NOC and NIC taxonomies that addressed frailty syndrome of the elderly, the risk of aspiration, chronic confusion with hallucinations and delusional ideas, and unstable emotional control, complemented by the identification of collaborative problems and potential complications (agitation and dementia itself). The case illustrates the time-based planning of objectives and their reassessment using the scales of the NOC taxonomy.
Identification of stressors in nursing degree students before starting their clinical training
Objective: to determine the stress factors declared by Nursing Degree students prior to the first period of clinical learning. Methodology: a cross-sectional descriptive observational study. The population were 129 nursing students of the Campus Docent Sant Joan de Déu, who had not started their clinical learning. A descriptive analysis of the variables included in the study is carried out, examining the relationship of each of them with the total score and with the scores of each factor of the validated Kezkak questionnaire. Results: the mean age was 22.6 years and 80.6% were women. 63.6% of the population studied had no previous experience. Analysing the relationship between the sociodemographic variables and the total questionnaire score, statistically significant differences were found regarding age (p = 0.008), in the sense that the older the student, the less the concern about the placements. The relationship between the questionnaire factors and the different variables showed statistically significant differences: between factor 3 and the shift (p = 0.024); between factor 5 and sex (p = 0.031); and between factors 1, 2, 4, 5, 8 and 9 and age. Conclusions: lack of competence, contact with suffering, powerlessness and uncertainty, and not being able to control the relationship with the patient are the situations that most concern students before their practical training.
Anxiety in the hospitalization of the paediatric patient
The hospital admission of the paediatric patient entails an alteration in the child’s daily life and is therefore a highly stressful experience both for the child and for their family. High levels of anxiety directly influence their recovery, increasing the length of hospitalization, medication consumption and the frequency of complications. It is essential that both the healthcare team that attends the child and their family, and the organization of the hospital, invest efforts in creating strategies that foster a more humanized hospital context, modifying those environmental and organizational conditions that are necessary to facilitate the adaptation of the patient and their family in the hospital, with the aim of avoiding the negative psychological reactions that appear during admission.
The role of nursing in the patient with dementia and behavioural disturbance
Copyright (c) 2015 Revista de Enfermería y Salud Mental
Borderline personality disorder: nursing approach from a psychiatric day hospital
Borderline personality disorder (BPD) affects 1-2% of the population, presents with high comorbidity and emotional instability and has a completed suicide risk of 8-10%, so it requires a multidisciplinary approach. We present the case of a 34-year-old woman with BPD, a history of an eating disorder and depressive episodes, admitted to a psychiatric day hospital for emotional instability with serious family, personal and occupational repercussions. The nursing assessment was carried out according to Marjory Gordon’s functional health patterns and a care plan was developed with the NANDA, NOC and NIC taxonomies (deficient knowledge, situational low self-esteem, interrupted family processes and ineffective coping), developed over four months through group psychoeducational activities. At discharge, the patient applied appropriate conflict-resolution strategies and had improved the quality of her family relationships and her level of confidence, underlining the need for continuity of care from the mental health centre.
The promotion of mental health is an essential component of nursing care that goes beyond the absence of illness. This work reviews the construct of Positive Mental Health (PMH) developed from the pioneering work of Marie Jahoda and operationalized by the author through a multifactorial model of six interrelated factors: personal satisfaction, prosocial attitude, self-control, autonomy, problem-solving and self-actualization, and interpersonal relationship skills, measured with the Positive Mental Health Questionnaire (PMHQ). It describes how nursing promotes PMH in two complementary ways: implicitly in all care interventions and as a specific activity aimed at reinforcing and maintaining the maximum possible level of health, both in situations of health and of illness. As an operational tool for practice, the Decalogue of Positive Mental Health is presented, ten recommendations applicable to the self-care of the professional and of the people cared for.
Pharmacological non-compliance is an important problem in the healthcare field that is accompanied by a high economic cost, which makes it necessary to detect the cause of non-compliance and what type of users engage in it. The observation of this reality by nursing leads us to reconsider questions such as the reason for treatment abandonment/non-compliance and what our relationships are like with patients who do not adhere to treatments. Finding answers to these questions is a relevant issue when it comes to contributing to increasing the quality of life of people with schizophrenia. In the last two decades, the topic has been researched and it is evident that nursing has an essential role in reducing relapses and improving social adjustment, which leads to better treatment adherence.
The impact of the economic crisis on the mental health of the population
The economic crisis that was triggered from 2008 onwards worldwide is causing devastating effects on the health of the population, especially mental health. This translates into an increase in consultations at primary care, mental health and basic social services settings. This article presents a qualitative, descriptive, exploratory and phenomenological study with content analysis, in which the exploratory hypothesis put forward is confirmed, since, indeed, the situation of economic crisis, which takes the concrete form of loss of employment, has adverse effects on the mental health of the people affected. Finally, the project to combat poverty and the risk of social exclusion carried out with the social dynamization groups is briefly presented.
First psychotic episode: nursing approach from an adolescent unit
The first psychotic episode (FPE) usually appears between the ages of 15 and 30, with scarce epidemiological data in the child and youth population. We present the case of a 17-year-old man, with a history of leukaemia and secondary diabetes, admitted to an adolescent unit for disorganized behaviour, cenesthetic and auditory hallucinations of mystical-religious content and delusional ideation, with the subsequent predominance of negative symptoms, refusal of treatment and of intake that required intramuscular medication and nasogastric intubation. The nursing assessment was carried out according to Marjory Gordon’s functional health patterns and a care plan was developed with the NANDA, NOC and NIC taxonomies, addressing the management of delirium and hallucinations, anxiety, fear, identity disturbance, impaired communication and social interaction, ineffective denial and spiritual suffering. After pharmacological stabilization and inclusion in an adolescent psychosis intervention programme, discharge was carried out with follow-up at the mental health centre.
Starting from Florence Nightingale’s observations on the therapeutic value of companion animals, this work presents horse-assisted therapy (HAT) or equine therapy as a complementary intervention to conventional rehabilitation in mental health. HAT is conceptualized as a technique aimed at specific objectives of prevention, rehabilitation and maintenance of health, based on the relationship that the person establishes with the animal in a natural, playful and non-stigmatizing environment. The author describes the fundamental role of nursing in this discipline and details the areas on which equine therapy can have an effect: motor, psychosocial, educational-cognitive and communication skills, with effects such as the improvement of muscle tone and balance, the reduction of anxiety, the increase of self-esteem and social interaction. It is concluded that HAT constitutes an adjuvant treatment with unique benefits that offers a new normalizing environment for psychiatric patients.
Postpartum depression is the most common affective disorder during the puerperium. No specific aetiopathogenesis is known to trigger this illness, but it has been shown that pregnant women with psychological risk factors have a greater probability of suffering from it, with the personal, family, social, economic and infant development consequences that this condition entails. It has been shown that a woman’s scarcity of internal resources to face and adapt to the psychosocial stress derived from motherhood favours the appearance of this pathology. The awareness of this reality on the part of nursing professionals leads us to reconsider the commitment to the prevention of puerperal depression through effective psychological strategies during pregnancy.
The stigma of mental disorders in nursing students
Introduction: people with mental disorders still suffer today from a strong stigma associated with their illness. Healthcare professionals and future nurses are key actors in reducing this stigma, fostering acceptance, integration and equality. Objectives: to identify the degree of stigma towards mental disorders in nursing students. Material and methods: a cross-sectional descriptive study of Nursing Degree students at the University of Girona. A sociodemographic data survey and the Community Attitudes Toward the Mentally Ill (CAMI), Reported and Intended Behaviour Scale (RIBS) and Mental Health Knowledge Schedule (MAKS) scales were administered. Results: 236 students took part (46.3%; n = 510), with a mean age of 22.02 (SD = 4.60) years. The MAKS (stigma-related knowledge) and CAMI (stigmatizing attitudes towards mental disorders) scales showed statistically significant differences (p ≤ 0.05) with taking the mental health subject and placement. The RIBS scale (future stigma-related intentionality) showed no relationship with any of the variables studied. Conclusions: nursing students show a good attitude and knowledge in relation to the stigma towards mental disorders, which improves after taking the mental health subject and practicum.
Current situation of mental health nursing
Patient with schizophrenia. From the hospitalization unit to rehabilitation: nursing approach
Schizophrenia is among the ten leading causes of disability in the world and its rehabilitation requires an approach that combines social skills training, personal management and social reintegration. We present the case of a 33-year-old man with paranoid schizophrenia and a borderline intellectual quotient, with 48 previous admissions for self- and hetero-aggression in the context of megalomaniacal delusional ideation secondary to substance use, poor treatment adherence and a pathological family relationship that led to his legal incapacitation. After nursing assessment according to Marjory Gordon’s functional health patterns, a care plan was developed with the NANDA, NOC and NIC taxonomies, addressing the tendency towards risk behaviours, readiness for enhanced health management, insomnia, deficient knowledge, disabling family coping and relocation stress syndrome. The patient’s evolution towards residential resources with less supervision illustrates the transition from hospitalization to rehabilitation and the progressive recovery of personal autonomy.
The importance of quality of life and functionality as a guarantee of the effectiveness of schizophrenia treatment
The work reviews the evolution of therapeutic objectives in schizophrenia, from the control of positive symptoms with first-generation antipsychotics to the current focus on functional recovery and quality of life. The role of second-generation antipsychotics is reviewed and, in particular, of long-acting injectables (LAIs) as a response to the lack of adherence, one of the main therapeutic challenges together with resistant forms. The results of the QUALIFY study are discussed, which compared monthly aripiprazole and paliperidone LAIs in 295 patients and showed the superiority of aripiprazole in quality of life and global clinical impression, especially in those under 35 years of age, also noting its methodological limitations. The author underlines the heterogeneous nature of the disease, the need for individualized treatment plans and the key role of the mental health nurse in managing these approaches.
The aim of this article is to address the fundamental findings of the scientific literature regarding recovery in mental health, covering its definition, some of the models that conceptualize it, different instruments to measure it and the key principles for incorporating recovery into mental health services. In the discussion, recovery is proposed as a paradigm shift; it is an evolution in the very understanding of the nature of mental disorders that goes beyond illness or the overcoming of symptoms. Recovery should be a support point for the growth and enrichment of the help to be provided to people who suffer from a mental health problem. The development of recovery-based mental health services is an opportunity, it can mark the path of where we are heading, although this would imply a profound change at many levels. However, for this it is necessary that the key values are integrated in users, families and caregivers, managers, promoters, politicians, etc., and to be able to work in a multidisciplinary way under this paradigm.