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Biomedical subjects

B Hannigan

Publications and source records attributed to B Hannigan.

At least 19 recordsLinked to original sources
PubMed2005

Factors influencing the effectiveness of clinical supervision.

Clinical supervision is widely accepted as an essential prerequisite for high quality nursing care. This paper reports findings from a study that aims to identify the factors that may influence the effectiveness of clinical supervision for community mental health nurses (CMHNs) in Wales, UK. Two hundred and sixty (32%) CMHNs from an estimated total population of 817 completed the Manchester Clinical Supervision Scale (MCCS) and a demographic questionnaire. The MCCS is a 36-item questionnaire measuring the quality and effectiveness of the supervision received. Three-quarters of CMHNs reported having participated in six or more sessions of supervision in their current posts. Clinical supervision was more positively evaluated where sessions lasted for over one hour, and took place on at least a once-monthly basis. Perceived quality of supervision was also higher for those nurses who had chosen their supervisors, and where sessions took place away from the workplace. These findings have important implications for the organization and delivery of mental health nursing services.

Adult↗
PubMed2001

Specialist practice for UK community mental health nurses: the 1998--99 survey of course leaders.

Surveys of the leaders of the UK's post-qualifying education courses for community mental health nurses have taken place, on an annual basis, for over 10 years. In this paper, findings from the survey undertaken in the 1998--99 academic year are reported. These findings include: that most course leaders do not personally engage in clinical practice; that interprofessional education takes place at a minority of course centres, and that course philosophies and aims are characterised by an emphasis on both outcomes (in terms of, for example, skills acquisition, knowledge development and the ability to engage in reflective practice), and process (adult learning).

Attitude of Health Personnel↗
PubMed2001

A stepwise multivariate analysis of factors that contribute to stress for mental health nurses working in the community.

AIMS: The aim of the study was to examine the variety, frequency and severity of stressors experienced by community mental health nurses (CMHNs) in Wales. BACKGROUND: Numerous studies undertaken throughout the United Kingdom (UK) have indicated that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout. Sample sizes have tended to be small and participants have been drawn mainly from sites in England. METHODS: A questionnaire booklet, which included a number of validated measures, was distributed to 614 CMHNs. These included Maslach Human Services Survey, Community Psychiatric Nursing (CPN) Stress Questionnaire, PsychNurse Coping Questionnaire, Rosenberg Self-Esteem Scale and General Health Questionnaire GHQ-12. The study was the largest of its kind conducted in the UK. RESULTS: Data were collected from 301 CMHNs, representing a response rate of 49%. Community mental health nurses identified the most stressful issues as trying to maintain a good quality service in the midst of long waiting lists and poor resources and having too many interruptions while trying to work in the office. The best demographic predictors of high stress scores were having an unsupportive line manager, working with a specific client group and not having job security. These factors accounted for 20% of the variance in the total stress score. When the results from the psychometric instruments were included, 46% of the variance in the total stress score was accounted for. The predictive variables were emotional exhaustion, working with a specific client group, job security and alcohol consumption. CONCLUSIONS: These findings indicate that there is a need to create more supportive environments both in terms of job security and management support, especially for those working in the fields of severe mental illness and rehabilitation.

Adult↗
PubMed2001

A discussion of the strengths and weaknesses of 'reflection' in nursing practice and education.

This paper begins by exploring the principles underpinning 'reflective practice'. The impact of reflection on the nursing profession is discussed, with particular attention being paid to nursing education. The value of reflective practice in nursing has been subject to considerable debate. This paper reviews both the claimed strengths and shortcomings of 'reflection', particularly in relation to the use of reflective material in the assessment of students.

Curriculum↗
PubMed2001

Mass media, 'monsters' and mental health clients: the need for increased lobbying.

A review of the limited empirical and theoretical literature indicates that current mass media representations of mental health service users appear to emphasize violence, dangerousness and criminality. This is despite the empirical evidence that indicates a decline over the last 40 years in the number of homicides carried out by people identified as suffering from mental health problems. Such inappropriate representations do much to increase stigma, ostracism, harassment and victimization of these individuals by the public. Furthermore, it can be argued that there is another repercussion of these representations and that is the subsequent government position/policy and the resulting legislation concerning care of people with mental health problems. Consequently, this paper argues that there is a clear need for psychiatric/mental health (P/MH) nurses to become more mindful of the wider, socio-political environment in which their practice occurs, particularly if psycho-social approaches to practice are adopted in their fullest sense, and as a result increase their political lobby. Such increased lobbying should occur on behalf of, and in collaboration with, service users, and accordingly the authors describe a range of activities under the broad headings of pro-active and reactive lobbying. Furthermore, it is incumbent upon P/MH nurse educationalists to prepare aspirant P/MH nurses for this lobbying role and equip them with the skills necessary to do so.

Humans↗
PubMed2001

Reviewing the review process: towards good practice in the peer review of manuscripts submitted to nursing journals.

Publishing in peer reviewed journals is an essential activity for nurses working in higher education. This paper offers some reflections on the processes involve in the reviewing of articles submitted for publication, and explores some ways in which this system may be improved. All journals operate some kind of review process. This can range from, at one end, the editor making decisions about the suitability for publication of a submitted paper to, at the other end, papers being blind-reviewed by two (or sometimes more) external referees. This paper notes that there appears to be little or no consistency amongst the various nursing journals with respect to reviewing processes. Suggestions put forward in this article for consideration include: the standardisation of peer review systems across journals; the construction of guidelines for referees which caution against ad hominem attacks on authors; and the introduction of 'open' reviewing.

Humans↗
PubMed2000

Qualitative and quantitative approaches in mental health nursing: moving the debate forward.

In recent years, two distinct, and apparently opposing, positions have arisen in debates concerned with mental health nursing research, education and practice. Each of the two has its champions and 'gurus', and its detractors. Writers associated with the quantitative camp have argued in favour of: experimental research where the aims are the investigation of the outcomes of nursing care; multidisciplinary rather than unidisciplinary research; a physiological explanation for mental illness; clinical practice which is evidence based, and skills based education. Qualitative camp writers, on the other hand, have argued for: qualitative research to explore the experiences of illness, and of nursing; the preservation of nursing-only research; the relative irrelevance of physical explanations of mental illness, and holistic nursing practice in which clinical techniques are less important than interpersonal relationships. In this paper, we first review and criticize some key ideas associated with these two positions. In our subsequent analysis, we argue that, rather than differing at some fundamental level, the differences found between the two camps may be more a matter of emphasis. The possibilities of reconciliation and synthesis are, finally, presented and discussed.

Clinical Competence↗
PubMed2000

Stress and burnout in community mental health nursing: a review of the literature.

There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within the UK. Seventeen papers were identified in the literature, seven of which looked at stress and burnout for all members of community mental health teams (CMHTs) and the remaining 10 papers focused on CMHNs. The evidence indicates that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout as a result of increasing workloads, increasing administration and lack of resources. For CMHNs specific stressors were identified. These included increases in workload and administration, time management, inappropriate referrals, safety issues, role conflict, role ambiguity, lack of supervision, not having enough time for personal study and NHS reforms, general working conditions and lack of funding and resources. Areas for future research are described and the current study of Welsh CMHNs is announced. This review has been completed against a background of further significant changes in the health service. In the mental health field, specific new initiatives will have a significant impact on the practice of community mental health nursing. A new National Framework for Mental Health, along with a review of the Mental Health Act (1983), will undoubtedly help to shape the future practice of mental health nursing.

Burnout, Professional↗
PubMed2000

Burnout in community mental health nurses: findings from the all-Wales stress study.

Stress and its outcomes are significant problems for mental health workers. Questionnaires were sent to 614 community mental health nurses (CMHNs) in Wales. Three hundred and one responded (49%). Of these, 283 completed the Maslach Burnout Inventory (MBI) (Maslach et al. 1996). Half of those who responded indicated that they were emotionally overextended and exhausted by their work. One quarter of respondents were found to possess negative attitudes towards their clients, and approximately one in seven experienced little or no sense of satisfaction with their work. Working in an urban environment and lacking a supportive line manager were indicators for higher emotional exhaustion. CMHNs were significantly more likely to have negative attitudes towards their clients if they: were male; worked with an elderly care caseload; lacked job security; and had an unsupportive line manager. However, CMHNs who had worked longer within the field of community mental health were more likely to have positive attitudes towards their clients. Those CMHNs who had not completed a specialist postqualifying education course and those who did not hold a supervisory or management position were found to have a lowered sense of personal satisfaction in their work. Those CMHNs who reported that they drank alcohol were more satisfied with their sense of personal accomplishments achieved in their work.

Adult↗
PubMed2000

Self-esteem in community mental health nurses: findings from the all-Wales stress study.

The authors conducted an all-Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used. These included the General Health Questionnaire (GHQ-12), Maslach Burnout Inventory (MBI), Rosenberg Self-Esteem Scale (SES), Community Psychiatric Nursing (CPN) Stress Questionnaire, and PsychNurse Methods of Coping Questionnaire. The findings from the Rosenberg SES are reported here. Community mental health nurses in Wales scored as having average self-esteem. When the data were divided into high and low self-esteem, a large group of CMHNs (40%) were found to have low self-esteem. Factors that are associated with low and high self-esteem were identified. Alcohol consumption and being on lower nursing grades (D, E, F) were associated with low self-esteem, whilst amount of experience working as a CMHN was associated with high self-esteem.

Adaptation, Psychological↗
PubMed2000

Community mental health nurses in Wales: self-reported stressors and coping strategies.

There is evidence to suggest that community mental health nurses experience stress and burnout related to their work. Previous research has been limited by a number of methodological problems. One of the problems is that studies have tended to have small or unrepresentative samples, and many researchers have only examined mental health nurses as a subset within their research, which limits the generalizability of the findings. The All-Wales Community Mental Health Nurse (CMHN) Stress Study was set up in order to address this issue. The total population of CMHNs in Wales was surveyed (N = 614) and 301 (49%) responded. The questionnaire booklet contained a number of validated instruments to measure stress, burnout, and coping, together with a demographic questionnaire. The demographic questionnaire included three open ended-questions. These questions were asked in order in determine the CMHNs' own views of the sources of stress in the workplace, and to investigate which methods they use to cope. This paper reports the findings from the content analysis of the three questions. The results from the other measures are reported in the companion paper (Edwards et al. 2000). The most frequently cited stressors included perceived workload, excessive paperwork and administration, and a broad spectrum of client-related issues. Coping strategies that CMHNs reported using included peer support, a range of personal strategies such as relaxation, and belief in self and supervision. It appears from the findings that a range of factors such as organizational pressures and factors related to working with patients are important in determining stress levels, and that informal rather than formal support networks are the preferred methods of coping.

Adaptation, Psychological↗
PubMed2000

Stressors, moderators and stress outcomes: findings from the All-Wales Community Mental Health Nurse Study.

The All-Wales Community Mental Health Nurse Stress Study was the largest study undertaken in the UK to date to investigate stress, burnout and coping amongst the CMHN workforce. The aim of the study was to examine the variety, frequency and severity of stressors, to describe coping strategies used to reduce work-based stress, and to determine stress outcomes. Questionnaires were sent out to 614 CMHNs from ten NHS Trusts throughout Wales. The response rate was 49% (n = 301). The measures used included the Maslach Human Services Survey, the CPN Stress Questionnaire, the Psychnurse Methods of Coping Questionnaire, the Rosenberg Self-Esteem Scale and the General Health Questionnaire GHQ-12. Community mental health nurses indicated that trying to maintain a good quality service in the midst of long waiting lists, poor resources, and having too many interruptions while trying to work in the office were particularly stressful items. The coping strategies that CMHNs utilized the most were having a stable home life and looking forward to going home at the end of the day, having outside interests and hobbies and talking to people that they got on well with. Forty per cent of CMHNs tended to view themselves negatively, feeling that others did not hold much respect for them. The GHQ-12 measure indicated that 35% of CMHNs had crossed a threshold of psychiatric caseness. Measured against a normative sample of mental health workers, 51% of CMHNs were experiencing high levels of long-term emotional exhaustion. Twenty-four per cent were suffering from high levels of depersonalization burnout and were not relating well to clients, whilst 14% were experiencing severe long-term feelings of lack of personal accomplishment. The results from the study provided us with a picture of stress and coping in CMHNs in Wales. Addressing these factors may help to reduce levels of experienced stress and burnout.

Adult↗
PubMed2000

Nursing, politics and policy: a response to Clifford.

Political decisions and social policy initiatives have an impact on the practice of nursing and on the provision of health care. In this paper, we develop the argument that nurses, therefore, need to have political awareness. Developing a critical approach to politics and policy in nursing includes, first, developing an awareness of the range of structural and ideological factors underpinning the emergence of policies. This, we argue, is an essential backdrop to the analysis of the impact on nursing and health care of specific policy initiatives. To illustrate this approach, we present a brief analysis of health policy under the last government, and consider how this came to impact on nursing. We then go on to outline health policy emerging under the present government, and consider how this reflects a commitment to 'third way' politics. Having considered the possible impact of new health policy on nursing, we suggest, finally, approaches to the teaching of politics and policy in nurse education programmes.

Attitude of Health Personnel↗
PubMed1999

Education for community psychiatric nurses: content, structure and trends in recruitment.

Under the auspices of the Standing Advisory Group for Community Psychiatric Nursing Education, annual surveys of the leaders of the UK's post-registration courses for community psychiatric nurses (CPNs) have taken place since the 1987-88 academic year. In this paper, findings are reported from the 1997-98 survey. Thirty-two of the 39 course leaders running post-qualifying programmes for CPNs (English National Board course 812 or equivalent, and Specialist Practitioner courses) in the 1997-98 academic year responded to a nine-page postal questionnaire. Responses suggested that the majority of courses for CPNs are now offered at first degree level, with most students completing their programmes of study and clinical practice in one full-time academic year. Most courses appeared to include education in key areas of specialist content pertinent to contemporary CPN practice. Examples included: evidence-based psychosocial interventions; collaborative working with users of mental health services; inter-professional issues; cognitive-behavioural interventions; reflective practice and clinical supervision; and medication-related issues. Overall, however, courses for CPNs appeared to be characterized by considerable variations in specialist content. Possible explanations for this are offered, along with suggestions for future research.

Career Choice↗
PubMed1999

Specialist practice in community mental health nursing.

Community mental health nurses (CMHNs) work in an increasingly complex health and social care environment. Over recent years, the evolving direction of general health service and specific mental health policy has directed CMHNs towards: the provision of clinically-effective interventions; a closer attention to meeting the needs of people experiencing severe and long-term mental health problems; the simultaneous provision of services to meet the needs of people experiencing a wide range of mental health problems presenting in primary care settings; greater collaboration with workers representing other disciplines and agencies; and the development of active partnerships with mental health service users. This paper explores the context within which CMHNs practise, and within which education programmes preparing specialist practitioners in community mental health nursing have been developed. One recently-validated specialist practice course for CMHNs is described in detail, with the intention of stimulating discussion and debate surrounding the practice of, and the educational preparation for, community mental health nursing.

Community Health Nursing↗