Nurses’ Perspectives on the Care of Adults with Mental Health Problems and Histories of Childhood Sexual Abuse

Chernomas, Wanda M; Mordoch, Elaine

doi:10.3109/01612840.2013.799721

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…Lack of theoretical knowledge and skills, organizational support and clinical supervision were identified as perceived barriers to the preparedness of MHNs to work with the issue of CSA. Unlike previous research, which reported that MHNs were reluctant or avoidant to engage with adults who had CSA histories (Chernomas & Mordoch, 2013;Chouliara et al, 2011;Lee, Coles, Lee, & Kulkarni, 2012), this study highlighted that MHNs were willing to engage with the issue of CSA, despite feeling unprepared to do so at times. In this study, MHNs undervalued their interpersonal skills when engaging with this client group based on their perception that they did not have a specific set of specialized skills to work with this client group effectively.…”

Section: Discussioncontrasting

confidence: 93%

Mental health nurses’ perceived preparedness to work with adults who have child sexual abuse histories

Kennedy

Morrissey

Donohue

2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? The high prevalence of adults presenting to the mental health services places mental health nurses (MHNs) in a unique position to help to identify and support the person with the associated challenges of child sexual abuse (CSA). Feelings of discomfort have been identified by mental health nurses (MHNs) when working with survivors of CSA due to a lack of knowledge, poor confidence and feeling unprepared to inquire and respond to such a sensitive topic. What does the study add to existing knowledge? MHNs are willing to engage in CSA dialogue; however, the level of engagement is often conditional with clear parameters set by participants. Whilst all participants reported they were willing to engage in conversation initiated by the service user, some were unwilling to listen to details of the CSA and used strategies to censor service users from providing details of the CSA. What are the implications for practice? Whilst self‐protecting boundaries helped MHNs to engage in CSA dialogue, strategies to censor aspects of the service user’s dialogue may reinforce the belief that their experience of CSA is too shameful to talk about, hence denying the reality of their experience and contributing to feelings of re‐shaming. MHNs need a combination of theoretical knowledge and psychosocial skills to achieve clinical competence when working with CSA; therefore, training should not only include information pertaining to facts and statistics but also case presentations, clinical training and supervision. Clinical supervision was highlighted by all participants as a necessary means of formal support, more specifically group clinical supervision whereby peer support can also be availed of in a formalized setting. Abstract IntroductionThe high prevalence of adults presenting to the mental health services places mental health nurses (MHNs) in a unique position to support the person with the associated challenges of CSA, yet little is known about the preparedness of MHNs to work with this client population. AimTo explore MHNs’ perceived preparedness to work with adults who have CSA histories, and to elicit their views, skills and confidence in relation to working with this sensitive issue. MethodIn‐depth semi‐structured interviews were conducted with five consenting MHNs. A qualitative descriptive methodology informed the study. A thematic analysis framework guided the data analysis. ResultsThe findings assert that MHNs are willing to work with survivors of CSA despite feeling unprepared to so, MHNs described feeling ill‐prepared in how to respond to CSA, calling for not just education and training specific to CSA but also citing the need for clinical supervision and additional guidelines to enhance their preparedness. DiscussionResults of this study further highlighted the omission of CSA within nursing curricula and the absence of role models within clinical practice as a major barrier to preparedness to work with survivors of CSA. Recommendations are made for training, e...

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Section: Discussioncontrasting

confidence: 93%

Mental health nurses’ perceived preparedness to work with adults who have child sexual abuse histories

Kennedy

Morrissey

Donohue

2020

Psychiatric Ment Health Nurs

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“…[121] Moreover, successful implementation of a psychotherapy intervention in Ethiopian primary care may provide support and a framework for interventions in highincome countries, where comorbid PTSD and SMI is still usually overlooked, and integration of EBIs for comorbid PTSD and SMI remains minimal. [10,13,[24][25][26][27][28][29][30][31][32] One of the central design considerations for this study was the selection of the BREATHE intervention [122,123] for adaptation and implementation. Although rst-line PTSD treatments such as CPT and PE have the largest evidence-base for PTSD treatment, trials have generally excluded people with SMI, and the interventions are highly intensive, leading to implementation challenges.…”

Section: Discussionmentioning

confidence: 99%

“…Successful implementation of a psychotherapy intervention in Ethiopian primary care may provide a framework for interventions in other low-resource primary care settings, including those in HICs, where comorbid PTSD and SMI is usually overlooked, and integration of EBIs for comorbid PTSD and SMI remains minimal. [10,13,[24][25][26][27][28][29][30][31][32] Despite the fact that PTSD may be higher in con ict-affected LMICs, and at least as prevalent in noncon ict LMIC settings, as compared to HICs, [33][34][35][36][37] many LMICs have extremely limited mental health services making implementation of EBIs challenging. [38,39] Low-income countries have less than one mental health provider per 100,000 people (compared to more than 50 in HICs), and almost all mental health services in low-income countries are provided in hospitals in large cities, with virtually no care available in rural areas.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder Intervention for People with Severe Mental Illness in a Low-Income Country Primary Care Setting: A Randomized Feasibility Trial Protocol

Serba

Dubale

et al. 2021

Preprint

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BackgroundIn this protocol, we outline a mixed-methods randomized feasibility trial of Brief Relaxation, Education and Trauma Healing (BREATHE) Ethiopia. BREATHE Ethiopia is a culturally and contextually adapted intervention for PTSD in participants with severe mental illness. BREATHE Ethiopia maps onto the World Health Organization’s guidelines for posttraumatic stress disorder (PTSD) treatment in low- and middle-income country primary care settings. MethodsSpecifically, this study includes a non-randomized pre-pilot (n=5) and a randomized feasibility trial comparing BREATHE Ethiopia to Treatment as Usual (n=40) to assess trial procedures, acceptability and feasibility of intervention delivery, and investigate potential effectiveness and implementation. In a process evaluation we will collect data that will be critical for a future fully randomized controlled trial, including the numbers of participants who are eligible, who consent, who engage in treatment, and who complete the assessments, as well as the feasibility and acceptability of assessments and the intervention. Qualitative data on facilitators and barriers to intervention delivery and quantitative data on provider fidelity to the intervention and participant and provider satisfaction will also be collected. Quantitative assessments at baseline, post-treatment, one-month follow-up, and three-month follow-up will assess change in mental health symptoms and functional impairment and hypothesized intervention mechanisms, including knowledge about PTSD, stigma, trauma-related cognitions, and physiological arousal. DiscussionFindings from this study will inform a future fully-powered randomized controlled trial, and if found to be effective, the intervention has the potential to be integrated into mental healthcare scale-up efforts in other low-resource settings. Trial RegistrationRegistered with ClinicalTrials.gov (NCT04385498) first posted May 13th, 2020; https://www.clinicaltrials.gov/ct2/show/NCT04385498?term=ethiopia&cond=PTSD&draw=2&rank=1.

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“…Indeed there is very high comorbidity between PTSD and psychosis (Grubaugh et al 2011; Bajor et al 2013) and PTSD and substance abuse (Schafer & Najavits, 2007; Dass-Brailsford & Myrick, 2010; McCauley et al 2012), and often PTSD is undiagnosed in these populations (Frueh et al 2002; Salyers et al 2004; Chessen et al 2011; Chernomas & Mordoch, 2013). As a result of this finding, greater attention is being paid to comorbid and underlying diagnoses at Icyizere.…”

Section: Discussionmentioning

confidence: 99%

“…Discussions with Icyizere staff also indicated that many psychotic disorders and substance use disorders were preceded by traumatic events and PTSD symptoms and these disorders may be complications from earlier trauma reactions. Indeed there is very high comorbidity between PTSD and psychosis (Grubaugh et al 2011; Bajor et al 2013) and PTSD and substance abuse (Schafer & Najavits, 2007; Dass-Brailsford & Myrick, 2010; McCauley et al 2012), and often PTSD is undiagnosed in these populations (Frueh et al 2002; Salyers et al 2004; Chessen et al 2011; Chernomas & Mordoch, 2013). As a result of this finding, greater attention is being paid to comorbid and underlying diagnoses at Icyizere.…”

Section: Discussionmentioning

confidence: 99%

Mental health care in post-genocide Rwanda: evaluation of a program specializing in posttraumatic stress disorder and substance abuse

Harerimana²

2016

Glob. Ment. Health

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BackgroundFollowing the genocide, millions of Rwandans are likely living with posttraumatic stress disorder (PTSD). Le Centre Psychothérapeutique Icyizere provides the only specialized treatment for PTSD in the Rwandan healthcare system.MethodsDemographics, diagnosis, treatment, outcomes, and scores on assessments of functioning and PTSD were recorded from clinical charts of all patients receiving care between October 2013 and 2014. Descriptive statistics and within-group t tests comparing functional impairment and PTSD symptoms at intake to discharge and follow-up were calculated.ResultsA total of 719 patients (55.08% male) received care. Patients were more educated, more likely to live in the capital, and less likely to be married than the general population. Patients reported high desire for, and strong satisfaction with, care. Most patients (55.60%) were still in care by the end of the program evaluation. Functioning improved from intake to discharge (p < 0.001), and improvements were sustained at follow-up (p < 0.001). Most adults were diagnosed with psychotic disorders, substance use disorders, or depression. Only 20 patients were diagnosed with PTSD, and symptoms were improved at discharge (p = 0.003).ConclusionsThis program evaluation demonstrated the utility of a low-resource information management system to provide clarity about the patient population and outcomes. Results suggest that services are effective and sustainable, although people with PTSD were not the primary recipients of care. Disparities in care by diagnosis, education, marital status, and geography are discussed. Results have contributed to changes in service delivery and care and efforts to increase access to care.

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Nurses’ Perspectives on the Care of Adults with Mental Health Problems and Histories of Childhood Sexual Abuse

Cited by 6 publications

References 31 publications

Mental health nurses’ perceived preparedness to work with adults who have child sexual abuse histories

Mental health nurses’ perceived preparedness to work with adults who have child sexual abuse histories

Posttraumatic Stress Disorder Intervention for People with Severe Mental Illness in a Low-Income Country Primary Care Setting: A Randomized Feasibility Trial Protocol

Mental health care in post-genocide Rwanda: evaluation of a program specializing in posttraumatic stress disorder and substance abuse

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