Nursing Practice Problem and PICOT Question: What effect does health promotion on mental wellbeing have on nurse use of psychiatric service treatment?

by lonnycherotich9gmailcom (student)

University Degree Subjects allied to Medicine

Quantitative and Quantitative Studies

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Quantitative and Quantitative Studies

Nursing Practice Problem and PICOT Question

PICOT Question: What effect does health promotion on mental wellbeing have on nurse use of psychiatric service treatment?

Population of choice: Nursing staff at the Oklahoma City Hospital

Intervention: Promotion of mental wellbeing

Control or Comparison group: Nurses that lack awareness on mental heath

Objective or Outcome: Advancement of mental wellbeing resources

Time: sensitization duration will run from the 26th of April to 19th May, 2021.

Background

The quantitative study by Tsaras et al. (2018) observed how nursing falls under the category of the most difficult and mentally exhausting careers. It is well accepted that most nurses struggle from stress and anxiety as a result of their jobs. Tsaras et al. (2018) conducted research to identify predictors of medical disorders risk by evaluating the prevalence and associated facets of anxiety and depression of care workers working in public psychiatric facilities. In terms of nursing relevance, identifying main variables that predict depression and anxiety in nurses' psychiatric facilities can help provide a better understanding of their mental well-being processes. It will also be beneficial in determining a subjective method for assessing, examining, forecasting, and creating optimum psychiatric health contexts caregivers and patients. As a consequence, the researchers' aim was to highlight the problem's importance in the current setting. The study question derived from this was: what is the prevalence of mental illness among psychiatric health caregivers operating in public mental institutions, and what factors bring about this?

Another quantitative study by Vasconcelos et al. (2016) investigated how the personal welfare of clinical staff participants affects the delivery of healthcare activities and their outcomes. Given the fact that there is a connection between job-related illnesses and the introduction of certain nursing practices, which leads to a rise in workplace stress and a reduction in staff morale and personal satisfaction, the workplace and job processes should be reviewed on a regular basis. The study's aim was to identify work-based factors that have a detrimental influence on nursing personnel's health emotion-wise, with the goal of discovering causes linked to workers' job activities methods that impact these practitioners’ psychological well-being. They came up with the following research issue as a result: What facets of the work activities for nursing employees have an undesirable effect on the personal wellbeing of these staff?

As for the qualitative analysis we have Tajvar et al. (2015) who used the study question: what is the prevalence of stress in the workplace among nurses working in the ICU of Shahid Mohammadi Hospital? to investigate how many caregivers have observed that they are subjected to elevated amounts of stress at work. As a result of stressful workplaces and operations, stress has an effect on nursing behavior in hospital units. The study’s aim was to determine how widespread mental issues and job stress are among Shahid Mohammadi Hospital ICU caregivers, as well as the connection between occupational stress and mental well-being. Occupational stress was found to be quite common among ICU workers, which has implications for nursing. Future strategies to collate a robust wellness program in this sector to reduce organizational stress and enhance psychological wellbeing of caregivers are required.

Also, Bak et al. (2020) did a qualitative study and noted that developing legislation to support nursing students' well-being is a high priority for healthcare institutions and policymakers around the globe. With the research issue: what are the nurses' opinions on causes of mental health issues and treatments that may benefit people with mental illness? the research aimed to determine nursing students’ perspectives on aspects that impact wellbeing-related practices and initiatives for improving psychiatric wellbeing (Bak et al., 2020). In terms of nursing importance, educational and environmental programs are required to support the health of student caregivers.

How do these ...

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How do these four articles support the nurse practice issue you chose?

Tsaras et al. (2018) quantitative study investigated the prevalence of mental illness in caregivers and the factors that lead to it, which addresses my PICOT question regarding the impact of health advocacy on mental wellbeing. Contrarily, Vasconcelos et al. (2016), looked into the connection between job-related factors and the incidence of mental disorders, which is similar to my research, that looks at psychiatric illness in the place of work. Considering that both papers discuss the mental wellbeing problems nurses experience in the workplace, the intervention classes in both papers are identical to those outlined in my PICOT query.

On the other hand, we have Tajvar et al. (2015) qualitative study that examined at occupational tension as a factor in depressive disorders among caregivers, which is related to my PICOT question regarding its impact of mental wellbeing on nurses. The study adds to our knowledge of the causes that contribute to cognitive illness in clinicians. The research of Bak et al. (2020) is relevant to the PICOT question since it addresses the same subject, which is psychological wellbeing promotion. The comparative populations in the papers are similar to those in my PICOT issue in that they all looked at how workplace tension affects intensive care nurses' and student nurses' perspectives on wellbeing-related habits and strategies for improving wellness.

Method of Study

For the quantitative studies, Vasconcelos et al. (2016) used an integrative review of literature, while Tsaras et al. (2018) used a cross-sectional study of descriptive nature. The descriptive cross-sectional examination is one under which the disease or condition, including its potentially underlying triggers are evaluated at a certain point in time in a specific population, whereas integrative analyses are the most extensive empirical assessment strategies, enabling for the integrated utilization of experimental and non-experimental analysis to offer a deeper highlight on an issue. A comprehensive cross-sectional study is a useful tool for performing studies since the knowledge retrieved can be utilized to estimate the prevalence of illnesses in a particular group. However, one disadvantage is that since risk and disease condition are measured simultaneously, causal results cannot be derived from this type of study. Contrarily, an integrative review of literature benefits a scholarly researcher in a variety of areas, such as assessing the strength of scientific findings and identifying important issues in a discipline. Even so, the combination and complexity of using a variety of methods in this analysis approach can result in a loss of comprehensiveness, discrimination, and precision.

Contrarily, Tajvar et al. (2015) used a focus group, whereas Bak et al. (2020) conducted a cross-sectional study in the qualitative studies. A focus group is a study technique for collecting data via social interaction comprised of a small number of carefully selected persons who discuss a particular topic, whereas cross-sectional analysis examines evidence from a particular community of people at a certain moment in time. In terms of benefits, focus groups encourage open and honest discussions about relevant issues because they have an atmosphere in which respondents do not feel overtly confronted about their health patterns attributable to the "cascade effect," which occurs because other people's remarks spark insights in others. Focus groups, on the other hand, can make it difficult to get reliable information on sensitive topics. Bak et al. (2020) used cross-sectional analysis, which is advantageous since investigators can quickly collect a large amount of evidence using cross-sectional trials. However, other variables could affect the association between the presumed cause and the outcome, so this form of research is not appropriate for drawing causal assumptions.

Results of Study

Tsaras et al. (2018) quantitative study found that many individuals were classified as depressed (52.7%) or tense (48.2%), with academic history, age, marriage status and work experience both being linked to anxiety and depression. Sex and rotated shifts, though, were not related to depression or anxiety. This research would help clinical administrators and nurses as they will be able to recognize and identify the triggers of psychological distress, and how they are linked. Employment expectations, violence, poor job interactions with employers, harassment, incidents concerning the danger of contracting HIV, exhaustion, and mistakes in completing work assignments, according to Vasconcelos et al. (2016), were the main related triggers of psychological health concerns. The most popular consequences of caregivers’ psychological health issues were depression, generalized anxiety, major depressive episode, and post-traumatic stress disorder (Vasconcelos et al., 2016). This study promotes comprehension of psychological wellbeing issues that caregivers encounter by demonstrating that their work methods include inconsistencies that increase their susceptibility to psychiatric disorders. Nursing staff should be mindful of the complexities of mental wellness among nursing personnel to understand, identify, and support the vulnerable individuals while simultaneously providing adequate psychiatric care.

Student nurses proposed health-promoting curricula, clinical environment change, and individual and group incentivization as main action initiatives to promote wellbeing among themselves as well as their clinical colleagues, specifically to promote healthier food choices and exercise, according to Tajvar et al. (2015) qualitative study. In terms of nursing considerations, this study seeks to assist student nurses in maintaining and improving their health-related habits, and also mitigating and managing scenarios that affect their psychiatric health. This will promote and inspire overall improvements in the well-being of nursing students, as well as cultivate a skilled future workforce which has the ability to respond to patients' and the general public's challenging medical and safety concerns. As per Bak et al. (2020), nursing staff operating during night shift had a 1.5 to 4.16 times greater frequency of somatic disorders, anxiety, stress, and mental disease than nurses those working during the day. Similarly, the most prevalent mental condition among partnered nursing workers was somatic symptoms (Bak et al., 2020). Undertaking educational programs to enhance communication skills, which could be beneficial in establishing appropriate interaction strategies, is one of the implications for nursing. Offering training programs tends to assist in the advancement of workplace safety and wellbeing.

Ethical Considerations

Participants must offer their consent to participate in study, and their anonymity and confidentiality must be guaranteed. In order for participants to accurately consider the risks of participation and make an educated, thoughtful, and willingly given choice about whether or not to take part, the principle of informed consent allows participants to have clear information and assumptions about involvement. Contrarily, confidentiality means that no person other than the researcher has rights to or is provided access to any publicized personal information. These considerations were taken into account in both experiments. Tajvar et al. (2015) received ethical approval from the university's research ethics commission. The personal information was made anonymous before examination, and participants in the survey provided their informed consent. Bak et al. (2020) took the university's standards on research study ethics into account. The physicians who participated were not allowed to keep their identities hidden in order to protect confidentiality. Each researcher had to sign a form of consent before they could begin participating in the study. As for Tsaras et al. (2018), the research was approved by local ethics boards. The study by Vasconcelos et al. (2018) used data that had been compiled from other researchers were utilized. As a result, they did not need the respondents' informed consent. Respondents' anonymity and confidentiality is protected because the information had already been checked for any sensitive or revealing details.

Comparison of Outcomes

According to the expected results of our PICOT query, advocating for mental wellbeing and use of resources directed at nurses can be effective in maintaining the mental safety of staff, and can be achieved by increasing knowledge of the provision of mental health treatment and building a friendly environment. The findings of the quantitative research selected for analysis support our predictions. Vasconcelos et al. (2016) goes into more detail on the mental health issues that nurses experience, pointing out that their work practices have inconsistencies that make them vulnerable to psychiatric disorders. Similarly, Tajvar et al. (2015) examined how widespread mental issues and job stress are among nurses in the intensive care unit, as well as the connection between occupational stress and mental well-being. This is the first move in making the necessary transition. Interventions aimed at promoting mental wellbeing can then be established as a result of this.

Contrarily, Tsaras et al. (2018), quantitative study found that many individuals were classified as depressed or tense, with academic history, age, marriage status and work experience both being linked to anxiety and depression. Also, Bak et al. (2020) found that nursing staff operating during night shift had greater frequency of somatic disorders, anxiety, stress, and mental disease than nurses those working during the day. Both these quantitative articles confirm the findings of my PICOT on the impact of clinical promotion on mental wellbeing as they demonstrate the need for it among clinical staff.

Proposed Evidence-Based Practice Change

The PICOT question investigated the effect nurse health promotion on mental wellbeing has on their use of psychiatric service treatment. This relates closely to what the quantitative and qualitative research articles we examined cover as they all examine how nursing work practices, individual lives, lifestyles, education levels and working hours impact their psychiatric health. It is from this that the necessary initiatives aimed at promoting mental wellbeing can be developed to mitigate the stressful work conditions which have been known to affect the practitioners’ emotional and psychological health and is a major nursing problem that needs to be addressed. To ensure that the change targeted at promoting mental wellness among nurses is successful, it is imperative that hospitals learn how to inspire, observe, and develop a supportive working atmosphere and a healthier lifestyle, along with a staff setting that promotes a good diet, fitness, and time with family, as well as time for positive reinforcement and acknowledgement of accomplishments (Thomas et al., 2016). Nurses should also be advised to have time set aside to participate in local economic formation, serve on advisory councils, contribute to management boards, and foster healthy mental well-being and health (Du et al., 2020). Also, it is important that facilities build a setting where health workers that have experienced bereavement or depression, are confronted by a life-altering illness can cultivate endurance to come back to work after they have healed.

References

Bak, M. A., Hoyle, L. P., Mahoney, C., & Kyle, R. G. (2020). Strategies to promote nurses’ health: A qualitative study with student nurses. Nurse Education in Practice, 48, 102860.

Du, M. L., Deng, W. X., Sun, W., Chien, C. W., Tung, T. H., & Zou, X. C. (2020). Assessment of mental health among nursing staff at different levels. Medicine, 99(6).

Tajvar, A., Saraji, G. N., Ghanbarnejad, A., Omidi, L., Hosseini, S. S. S., & Abadi, A. S. S. (2015). Occupational stress and mental health among nurses in a medical intensive care unit of a general hospital in Bandar Abbas in 2013. Electronic physician, 7(3), 1108.

Thomas, S., Jenkins, R., Burch, T., Calamos Nasir, L., Fisher, B., Giotaki, G., ... & Wright, F. (2016). Promoting mental health and preventing mental illness in general practice. London journal of primary care, 8(1), 3-9.

Tsaras, K., Papathanasiou, I. V., Vus, V., Panagiotopoulou, A., Katsou, M. A., Kelesi, M., & Fradelos, E. C. (2018). Predicting factors of depression and anxiety in mental health nurses: a quantitative cross-sectional study. Medical Archives, 72(1), 62.

Vasconcelos, S. C., de Souza, S. L., Sougey, E. B., de Oliveira Ribeiro, E. C., do Nascimento, J. J. C., Formiga, M. B., ... & Silva, A. O. (2016). Nursing staff members mental’s health and factors associated with the work process: an integrative review. Clinical practice and epidemiology in mental health: CP & EMH, 12, 167.