No abstract

Citation: Robson, D., Haddad, M., Gray, R. & Gournay, K. (2013). Mental health nursing and physical health care: a cross-sectional study of nurses' attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness. International Journal Of Mental Health Nursing, 22(5), pp. 409-417. doi: 10.1111/j.1447-0349.2012.00883.x This is the accepted version of the paper.This version of the publication may differ from the final published version. University of East Anglia, Norwich, UK *These authors contributed equally to this study. Permanent AbstractMental health nurses have a key role in improving the physical health of people with a serious mental illness, however there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical healthcare and explore associations with their practice and training.A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n=585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice re cancer screening and smoking cessation. Having received post-registration physical healthcare training and working in in-patient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post-registration physical health training or had an additional adult/general nursing qualification.Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognised. However there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.

High-quality data examining patient and nurse attitudes regarding depot antipsychotics are sparse. What data there are show a positive attitude to depots from patients. Future randomised controlled trials should include satisfaction as an outcome.

Non-compliance with antipsychotic medication is observed in around 50% of people with schizophrenia and is a major preventable cause of psychiatric morbidity. A number of factors influence patient's decisions about taking medication and include awareness of illness, beliefs about treatment and side-effects of medication. A variety of interventions targeted at improving compliance have been tested. Education increases patients' understanding of their illness and treatment but does not improve compliance. However, interventions, such as compliance therapy, based on cognitive-behavioural techniques appear to be effective in enhancing compliance and preventing relapse.

A postal questionnaire survey was employed in regional secure and psychiatric intensive care units in England and Wales, in respect of mental health nurses' training in the use of physical restraint. The nurses' views were sought relating to their last experience of implementing the procedure. Whilst most nurses (n = 259, 96.3%) reported positive outcomes in so far that the incident was brought under control, the views of the aftereffects of the procedure were of concern and ambivalence. The literature suggests that service users did not necessarily hold the same positive views. A range of alternatives, which were consistent with the literature, was made by staff to improve intervention in the management of violence. Negative aspects relating to the use of physical restraint were also highlighted. They included procedural, injury, clinical and management issues. Some respondents also expressed concerns about the negative attitudes of their colleagues. The findings of this aspect of the survey highlights that the therapeutic value of physical restraint can only be achieved with appropriate monitoring and with emphasis on psychological intervention in the prevention and management of violence.