Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study

ObjectivesTo develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.DesignWe developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity.SettingThe study’s setting was psychiatric facilities in three prefectures in Japan.ParticipantsData from 514 valid responses were extracted of the 786 responses by psychiatric nurses.Outcome measuresThe study measured the reliability and validity of the scales.ResultsThe ISES has two factors (‘Positive changes in the patient’ and ‘Prospect of continuing in psychiatric nursing’) and the DSES has three (‘Devaluation of own role as a psychiatric nurse’, ‘Decrease in nursing ability due to overload’ and ‘Difficulty in seeing any results in psychiatric nursing’). With regard to scale reliability, the Cronbach’s alpha coefficient was 0.634–0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ2/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ2/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149–0.446 (p<0.01) for ISES and r=−0.154 to −0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=−0.128 to 0.168 for ISES, r=0.214–0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures.ConclusionsThe ISES and DSES can accurately assess psychiatric nurses’ self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses’ feelings of self-efficacy.

Determining the Role of Psychiatric Nurse for Client Receiving Anti-Psychotic Drugs in India

The prevalence of mental diseases is increasing. Even the average person suffers from minor issues such as stress and anxiety due to various causes. Clients having psychiatric consultations require support and exceptional care from a psychiatric nurse; these clients are given multiple drugs with varied side effects that must be managed; the nurse is only present with the patient and manages the patient. As a result, this article discusses the numerous roles that a psychiatric nurse can play in this regard.

A survey of personnel and services offered in 32 outpatient US clozapine clinics

Background Clozapine clinics can facilitate greater access to clozapine, but there is a paucity of data on their structure in the US. Methods A 23-item survey was administered to participants recruited from the SMI Adviser Clozapine Center of Excellence listserv to understand characteristics of clozapine clinics. Results Clozapine clinics (N = 32) had a median caseload of 45 (IQR = 21–88) patients and utilized a median of 5 (IQR = 4–6) interdisciplinary roles. The most common roles included psychiatrists (100%), pharmacists (65.6%), nurses (65.6%), psychiatric nurse practitioners (53.1%), and case managers (53.1%). The majority of clinics outreached to patients who were overdue for labs (78.1%) and had access to on-site phlebotomy (62.5%). Less than half had on call services (46.9%). Conclusions In this first systematic description of clozapine clinics in the US, there was variation in the size, staffing, and services offered. These findings may serve as a window into configurations of clozapine teams.

I Call This Institutionalized Rape

I once wrote a statement to make clear that I didn’t consent to involuntary injections. Against the institutional power that included the threat of increased force—at each encounter with the psychiatric nurse, security staff on the ready, week after week—I read aloud this statement asserting that my submission should in no way be understood as consent. At its end I explained that one day I would write and publish an essay titled “I Call This Institutionalized Rape.” This is that essay.

Improving Access to Integrated Behavioral Health in a Nurse-Led Federally Qualified Health Center

BACKGROUND: The specific aims of this project were to create a fully integrated, nurse-led model of a psychiatric nurse practitioner and behavioral health care team within primary care to facilitate (1) patients receiving an appropriate level of care and (2) care team members performing at the top of their scope of practice. METHOD: The guiding model for process implementation was Rapid Cycle Quality Improvement. Three task forces were established to develop interventions in the areas of Roles and Responsibilities, Training and Implementation, and the electronic health record. INTERVENTION: The four interventions that emerged from these task forces were (1) the establishment of patient tiers based on diagnosis, medications, and risk assessment; (2) the creation of process maps to engage care team members; (3) just-in-time education regarding psychiatric medication management for primary care providers; and (4) use of a registry to track patients. RESULTS: The process measures of referrals to the psychiatric care team and psychiatric assessment intakes performed as expected. Both measures were higher at the onset of the project and lower 1 year later. The outcome indicator, number of case reviews, increased dramatically over time. CONCLUSIONS: For psychiatric nurse practitioners, this quality improvement effort provides evidence that a consultative role can be effective in supporting primary care providers. Through providing education, establishing patient tiers, and establishing an effective workflow, more patients may have access to psychiatric services.