Biomedical subjects

Adele Freeman

Publications and source records attributed to Adele Freeman.

11 recordsLinked to original sources

PubMed2006

Patient and carer perceptions of need and associations with care-giving burden in an integrated adult mental health service.

OBJECTIVE: To identify patients' and carers' perceptions of need in inpatient and community settings and investigate the relationship between need and caregiver burden. METHOD: The study was conducted across a metropolitan mental health service in Sydney, Australia. Patients (n = 407) and carers (n = 50) completed the Camberwell Assessment of Need Short Appraisal Schedule. Carers also completed a shortened version of the Involvement Evaluation Questionnaire to assess caregiver burden. RESULTS: When completing the assessment tools, patients and carers in hospital settings were asked to consider the 4 weeks preceding hospitalisation; in the community, patients and carers were asked to consider the previous 4 weeks. These data show a high percentage of patients in hospital and community settings have unmet needs for company, daytime activities and intimate relationships. Inpatients had more unmet needs than community based patients. Agreement between patients' and carers ratings' of need ranged from 'poor' to 'moderate'. There was a strong relationship between unmet need and burden from the carer's perspective. Patients with and without carers had similar numbers of needs. Carers of patients recently admitted to hospital reported a significantly higher burden. CONCLUSIONS: Carers of inpatients experienced significantly more burden than carers of outpatients. Opportunities to access support, information and education should be readily available and not contingent upon demonstrating a close familial relationship to the patient. We found that unmet need was significantly related to burden, suggesting that meeting patient needs could reduce carer burden.

Adult↗

PubMed2006

Fostering a culture of support in mental health settings: alternatives to traditional models of clinical supervision.

Clinical supervision [CS] for mental health nurses in inpatient settings in Sydney, Australia, is virtually nonexistent despite over a decade of discussion regarding its benefits to staff, patients, and organisations. Whilst there is general agreement about the merit of CS, its ad-hoc implementation and the use of models that do not correspond to the realities of the environment have led to its adoption being somewhat half-hearted. It is unsurprising then that there is an absence of achievable policy regarding CS making its integration into modern inpatient units even harder to attain. In this paper, we outline some pragmatic issues concerning CS and advocate for facility-specific professional development and support processes that incorporate succession planning opportunities. This we believe has the potential to promote professional behaviour, continuous learning and development, cohesive teamwork, and ultimately a change in culture regarding CS.

Culture↗

PubMed2006

Carer participation in mental health service delivery.

There is increasing emphasis on enhancing consumer and carer participation in the planning and provision of mental health services. However, health professionals, consumers, and carers have different perceptions about what constitutes optimal care; identifying, negotiating, and meeting their respective needs can be challenging. The aim of the paper is to highlight the challenges of facilitating carer participation in daily practice and emphasize the broader issues that would benefit from more extensive discussion among health professionals. By examining the strategies used to enhance consumer participation, there is the potential to avoid many of the mistakes of the past and create a flexible and responsive framework to increase carer involvement. The authors anticipate that this discussion will resonate with many clinical staff as well as carers themselves. Identifying barriers to carer participation opens the way to promoting collaboration and enhancing care.

Attitude to Health↗

PubMed2005

The development, implementation, and evaluation of a clinical leadership program for mental health nurses.

A structured clinical leadership program was developed to assist nurses working in a metropolitan mental health service to develop and consolidate clinical leadership skills. The Nurses' Self-Concept Questionnaire (NSCO) was used to elicit responses from participants prior to commencement of the leadership program and again at completion. Findings indicate that the program was considered useful and its benefits were carried over into the workplace via the sharing of information. The self-directed nature of this program was found to be an effective way for clinical nurses to undertake continued professional development within the exigencies of clinical practice.

Adult↗

PubMed2005

The cultural realities of clinical supervision in an acute inpatient mental health setting.

In this paper, the cultural realities of clinical supervision (CS) in acute inpatient mental health settings are explored using an ethnographic approach. Findings suggest that there is a verbal acceptance of CS by mental health nurses but a cultural belief that it has limited experiential value and, thus, a cautious attitude towards its adoption is in practice. This may, in part, be attributable to many nurses believing that they are already undertaking CS, although the informal supervision described does not fit with established definitions of formal supervision. The language used by nurses demonstrates an understanding and appreciation of the benefits of clinical supervision. However, the belief that existing structures inherent to nursing practice already convey these benefits may contribute to the culture of passive resistance to clinical supervision revealed by the findings. This study contributes to current discussions regarding the purpose of CS, the realities of its implementation, and its role relative to existing professional support opportunities.

Acute Disease↗

PubMed2005

What patients and carers want to know: an exploration of information and resource needs in adult mental health services.

OBJECTIVE: The objectives of this study were to: (i) obtain baseline data on the extent of carer involvement across a representative sample of hospital and community patients within an integrated area health service; and (ii) examine perspectives on discharge planning and community care among patients and their carers to identify information and resources they consider important. METHOD: Over a 4-month period, inpatients before discharge and patients accessing community mental health services participated in face-to-face interviews. Information was collected about carer involvement and, with the patient's consent, the identified carer was sent a similar survey to determine demographics and information needs. This resulted in a representative sample of patients and carers accessing inpatient and community settings across a metropolitan mental health service. Support needs and carer burden were also assessed but are not reported here. RESULTS: A total of 407 interviews were completed, 207 in inpatient settings and 200 in the community. An inpatient response rate of 70% and a community response rate of 75% was achieved. Across both settings, 67% of patients identified a carer and a carer response rate of 28% was then obtained. We found carers and patients have different priorities regarding the information they want and information is often not provided to carers. Furthermore, patients were more confident in their ability to manage their mental health in the community than carers. CONCLUSIONS: This study yielded important baseline data about the number of patients who have a carer. We were also able to determine that routine clinical information provided to patients and carers is inadequate from their perspective. It is anticipated that this initiative will assist ongoing service planning and improve partnerships with patients and their carers.

Adult↗

PubMed2005

Email etiquette: guidelines for mental health nurses.

This note is about the use of email and its role in mental health settings. We anticipate that it may be of assistance to mental health nurses unfamiliar with the benefits and pitfalls of email and wanting to learn more about how to use it professionally and effectively. In mental health nursing, we pride ourselves on our interpersonal skills and being able to communicate. However, transferring these skills to an electronic medium is not always easy. Because many of us are self-taught, there is potential for email to be a hindrance rather than a help in the quest for good collegial relationships. In this note, we discuss some of the common situations that can arise when email use goes awry and provide some helpful tips for getting the most out of email. It is hoped that the information and checklist provided in this paper will strike a chord with many, encouraging discussion and promoting appropriate use of this form of communication.

Electronic Mail↗

PubMed2005

Facilitating research within clinical settings: the development of a beginner's guide.

Increased consumer participation, clinical governance, accreditation, and occupational health and safety requirements have contributed to considerable changes in the demands placed upon mental health staff, and many are now expected to undertake or participate in research. However, many staff have not received formal training in research design and methodology, and the multitude of policies, procedures, and committees, designed to protect research participants, can seem like insurmountable barriers to clinicians new to the field. In response to this, a guide was developed based on self-directed learning principles, to compliment other resource material and promote effective research work. It was considered important to clarify some of the issues surrounding research development, ethics, and scholarly integrity, and to educate staff as to the appropriate approval processes, which must be followed before embarking on research work. This paper seeks to describe the process of developing a guide for novice researchers, its key characteristics, and its implications for practice. The guide 'Undertaking research: a guide for the beginner' described in this paper, provides a helpful resource that can be readily adapted and developed for a variety of workplaces and professional backgrounds. It is a strategy intended to encourage research and ongoing education and narrow the research-practice gap while placing minimum demand upon existing organizational infrastructure.

Clinical Nursing Research↗

PubMed2005

Self-directed learning and portfolio development for nurses: developing workbooks as a facilitative tool.

Workbooks are often used for discipline-specific learning in academic institutions but there is growing recognition of their potential usefulness in the clinical setting to promote learning and professional development. The purpose of this paper is to share some tips/guidelines for those clinical staff interested in developing self-directed learning programs using a workbook approach. Combined with skilled facilitation, custom designed workbooks based on adult learning theories can enhance skills and encourage portfolio development in the clinical setting. This cost and time effective approach utilises existing resources to cater to diverse needs and topics, building sustainable collaborations. This paper will argue that the proposed program has the potential to contribute to healthcare improvement by promoting skill development amongst staff and contributing to evidence-based practice.

Clinical Competence↗

PubMed2005

Making evidence based practice a reality for mental health nursing.

In recent years, efforts have been directed towards making mental health nursing more evidence-based. Making evidence based practice (EBP) a reality in modern health services requires due attention to service planning and management. It is acknowledged that there are many challenges and barriers to implementing EBP as outlined in this article. However, by using an example from our mental health service and drawing upon the literature, we show that a variety of techniques can be used to incorporate EBP into everyday practice. A combination of approaches is recommended, including education and training, leadership programs, research units, dissemination of research findings and structural changes to draw upon the expertise of key clinical, education, management and research staff.

Australia↗

PubMed2004

A statewide survey of high-support services for people with chronic mental illness: assessment of needs for care, level of functioning and satisfaction.

OBJECTIVE: The primary aim of this study was to describe high support accommodation services available for patients with chronic mental illness living in New South Wales (NSW). The second aim was to ask patients in these facilities about their needs and satisfaction with services and to assess their level of functioning. METHOD: Non-inpatient services matching NSW Health's definition for high support, very high support and residential rehabilitation were sent a survey regarding type of service, criteria for acceptance, choice of housing options, patient demographics, evaluation methods and staff details. The Camberwell Assessment of Need was used to assess needs and the Life Skills Profile-16 was used to assess level of functioning. Comparisons were made between services operated by NSW Health and non-government organizations (NGOs), rural and urban services and services providing 24-hour support and those with less intensive staffing. RESULTS: Forty of the 42 identified services were included in the survey (95% response rate) of which 25 were operated by NGOs. There were 753 residential beds and 1132 patients lived in these facilities over the financial year 2001/2002. Interviews were completed at 25 locations across the state with 159 patients. Seventy-four percent were male and the mean age was 43 years. Patients had on average 7.6 needs of which 2.2 were unmet and their mean LSP-16 total score was 16.8. Almost half the patients responded that they were homeless at one time because they could not find appropriate housing. CONCLUSIONS: There were no significant differences in the number of needs expressed by patients residing in government or non-government operated services, those living in rural or urban areas and those in 24-hour services compared to patients in less intensively staffed services. Existing services are doing a good job of meeting patients' needs for practical assistance, but social and psychological needs remain unmet for a significant proportion.

Adult↗