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Revalidation: The Benefits -Student Nurse Ceire blogs

CeireCasey1The recent approval of revalidation by the Nursing and Midwifery Council is a topic in which has initiated many debates and discussions over the past few months. The process, designed to strengthen the three-yearly registration renewal process, aims to increase professionalism amongst nurses.

Initially, many argued against revalidation, as they feared the introduction would be a burden which could spark a surge in the number of fitness to practice referrals. However, after pilot procedures and test studies were carried out with over 2,700 participants, early data analysis discovered the process to be straightforward and beneficial.

In order for nurses and midwives to revalidate every three years, they are required to undergo 450 practice hours, 35 hours of continuing professional development, five pieces of practice related feedback, five written reflective accounts, a reflective discussion, a health and character declaration, a professional indemnity arrangement, alongside confirming they have met the revalidation requirements.

The introduction will be influential to all nurses as it promotes a culture of professionalism by taking responsibility for their own professional development where they can reflect and focus on their own behaviours in the workplace, rather than those of others. This will empower them to make positive changes within their practice, through small improvements, whilst promoting and maintaining higher standards and quality of care within the NHS.

It will also help to extinguish the blame culture, by focusing on what we could do differently to avoid errors in the future.

Finally, it will also enhance public protection and patient safety, along with increasing the public’s credibility for nurses, as nurses will consciously be focusing on the quality of care given to their patients.

As a current student, revalidation will affect me from the moment I graduate. For example; students who are due to graduate in August 2016 will be due to revalidate in August 2019. For current students it may be easier to adapt and adjust to as it is already a requirement as opposed to trying to get used to the introduction of it.

We are also in a fortunate position as we already spend a considerate amount of time working on modules and reflections, in order to enhance our learning and to allow for self-improvement. Personal learning and development is a life-long experience within the nursing profession, and it allows us to maintain high standards of care, enhance our care skills and further develop our knowledge base. The introduction of revalidation will raise the standards of nursing, and promote professionalism, making nursing an attractive profession for prospective students.

Ceire Casey, Mental Health Student Nurse
21 December 2015

Survey of new mothers highlights improvements

Photo of Prof Helen Cheyne

Prof Helen Cheyne

The state of maternity care in Scotland has been examined by University of Stirling researchers working with the Scottish Government.

The national report Having a baby in Scotland 2015: Listening to Mothers documents the story of more than 2000 new mothers.

Produced in partnership by the Scottish Government and Stirling’s Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU) – it shows women are accessing care earlier in pregnancy with significantly more contacting a midwife first when they are pregnant.

Communication between women and maternity care staff appears to be good with most women reporting that they were listened to, spoken to in ways that they could understand and involved as much as they wanted in decisions about their care. The high level of trust women had in staff was evident, in particular during labour and birth.

Areas where care could be improved – particularly in relation to mental health – were highlighted, based on women’s responses to the survey.

Around one third of women felt that they were not given all the advice they needed about emotional changes they might experience and around one quarter were not given information about who to contact for advice about emotional changes if they needed it.

Additionally 44 percent of women said they did not get enough information to help them decide where to have their baby and 24 percent said they were not offered a choice about where to have their baby.

Report author Helen Cheyne, midwife and Professor of Midwifery Research in the NMAHP Research Unit at the University of Stirling said: “One of the most striking findings was around women’s mental health in the six weeks following birth. A recent report shows that almost a quarter of women who died between six weeks and one year following birth did so from mental health related causes. It is essential that all women and their families know the signs and symptoms of mental health problems following birth and who to contact if these occur.

“The report recommends that NHS Boards should examine whether local maternity and perinatal mental health services meet current best practice recommendations to support maternal mental health. All midwives, health visitors and medical staff caring for pregnant and postnatal women should undertake recognised training to ensure there is support for mothers who experience mental health problems.”

The report from the NMAHP Research Unit concludes with six recommendations including the appointment of post-natal care champions in every maternity hospital, ensuring one to one care of women by skilled midwives throughout labour and birth remains a priority and that all women should have choices about where their antenatal and postnatal care and place of birth happens.

Media enquiries to Corrinne Gallagher, Communications Officer, on 01786 466 687 orcorrinne.gallagher@stir.ac.uk

15 December 2015

Looking at the whole picture: Mental, physical and social assessment

Photo of Prof Margaret Maxwell

Prof Margaret Maxwell

Prof Margaret Maxwell has blogged for the National Institute for Health Research this weekend:

“A quarter of the UK population will experience some kind of mental health problem during their lives, most commonly depression and anxiety. The likelihood of someone with physical health problems also experiencing mental health problems is now well recognised, although the nature of the relationship between depression and physical disease or illness remains ambiguous.”

Read the full article here: http://www.nets.nihr.ac.uk/mental-health-matters/looking-at-the-whole-picture-mental,-physical-and-social-assessment

High quality reporting is required in research studies – a recent review highlights why

Photo of Nadine Dougall

Nadine Dougall, University of Stirling

One in one hundred people will experience schizophrenia in their lifetime. Schizophrenia can be managed well with a person-centred combination of therapy and medication and an emphasis on recovery. Many of us are likely to know people who are affected by the symptoms of schizophrenia but are still managing to lead fairly ordinary lives.

However, for others living with more severe symptoms, schizophrenia can be a distressing and highly debilitating experience. Symptoms experienced such as hearing voices or seeing things (hallucinations) often fail to respond to medication. Even when antipsychotic medication is effective, the side effects of weight gain, apathy, shaking or lack of drive are also debilitating. More effective drugs are urgently needed, however despite promising leads there has not been ground-breaking progress in drug development for schizophrenia for many decades.

One emerging non-drug therapy proposed for the treatment of schizophrenia and the symptom of hearing voices is transcranial magnetic stimulation (TMS). TMS is a device which involves the skilful application of a strong magnetic field close to the scalp surface. TMS is a relatively painless and non-invasive technique which stimulates parts of the brain. Researchers over the last decade have set about assessing whether this promising new therapy TMS could be an alternative treatment for people who do not respond, or do not cope well with medication.

Researchers have typically used ‘randomised controlled studies’ to assess the effectiveness of TMS. This has usually meant randomising people with schizophrenia – with their full consent – into an experiment of either having TMS or having ‘sham’ TMS (i.e. identical process without the magnet switched on). Therefore, randomised controlled studies are a way of comparing two groups of people with schizophrenia who are as identical as possible in every way except for the active ingredient of the TMS itself.

Although many of these study results have now been reported by researchers across the world, the results differed widely and there was no consensus on whether TMS should be routinely used in practice. Therefore we set out to achieve this consensus by reviewing all the reported TMS studies of schizophrenia using Cochrane methodology (the internationally recognised highest standard of review). The purpose of our Cochrane review was to assess the quality of all reported studies, and then combine the results into one analysis (a ‘meta-analysis’) to give summary estimates of whether TMS is effective, or not.

We found that from 41 reported studies (1473 people) there was some evidence to suggest TMS may improve certain symptoms such as hearing voices when compared with ‘sham’ TMS. However, because we also graded many of the studies as ‘low’ or ‘very low’ quality evidence, this meant we were uncertain that TMS was effective, and could not make firm conclusions about using TMS as routine treatment for schizophrenia.

To be clear, this is not the same as researchers doing low quality studies, but rather that frequently the way the study was conducted was not reported to a sufficient standard to rule out risks of bias. This is frustrating, and authors who are reporting on study results are urged to adopt clear reporting practices to remove ambiguity by using standards such as the CONSORT criteria. Journal editors should consider routinely recommending the use of CONSORT criteria and lift restrictions on word limits which inhibit full reporting.

In future, high quality research studies AND high quality reporting of these studies is very likely to have an important impact on whether we can confirm TMS alleviates some symptoms of schizophrenia, but for now we remain quite uncertain. It is important that the research community pursues this aim so that we can improve the quality of treatment provided to people who are living with the debilitating symptoms of schizophrenia.

N Dougall
1 October 2015 

Reference:
Dougall N, Maayan N, Soares-Weiser K, McDermott LM, McIntosh A. Transcranial magnetic stimulation (TMS) for schizophrenia. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.:CD006081.
http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD006081.pub2