14^th World Congress on Psychiatric & Mental Health Nursing July 25-26, 2018 Vancouver, Canada

Professor Beata Karakiewicz - Dean of the Faculty of Health Sciences at Pomeranian Medical University in Szczecin for the 2012-2020 term. Since 2005, the Head of the Department of Social Medicine and Public Health, Chair of Social Medicine. Her main point of interest in research are the issues concerning public health and environmental medicine. Author of many publications touching on the problems of disabled people - both physically and mentally, the chronically ill, people addicted to psychoactive drugs and HIV-positive people.

Introduction: Violence is a common phenomenon in everyday life. It can affect anyone, regardless of gender, age, health or economic status. Increasingly, attention is being paid to violence against women, children, the elderly and people with disabilities, but there is still little talk about violence experienced either by people with mental disorders. The aim of the study was to analyze the phenomenon of violence among people treated psychiatrically in the municipality of Szczecin, Poland. Material and methods: The research was carried out in Poland, in 2017, by means of a diagnostic survey. Our own questionnaire was used for the study. It was used to carry out research on the phenomenon of violence among 95 people who were psychiatrically treated, using help in day care centers for people with mental disorders. Respondents answered questions about various aspects of the phenomenon of violence. They filled the questionnaire in the presence of a therapist, psychologist or social worker. Results: Men treated psychiatrically more often experienced violence than women. The average age of the respondents was about 45 years. Almost all respondents were single people (87 people). Physical violence was the most common among people treated psychiatrically and experiencing violence (Fig. 1). Conclusions: Violence in the psychiatric community is a long-term phenomenon. The dominant duration of victim violence is 5 years and more. It is essential to introduce tools to verify the occurrence of violence among psychiatric patients by therapists performing tasks for psychiatric patients.

Paulina Zabielska, PhD - Employee of Department of Social Medicine and Public Health, Chair of Social Medicine of the Pomeranian Medical University in Szczecin. Her main point of interest in research are the issues concerning public health and environmental medicine

Introduction: The EUROSTAT data shows that Poles occupy one of the last places among the residents of the EU who feel psychologically well. Meanwhile, subject literature treats optimism as a resource that makes life easier for everyone. The purpose of the research was to analyse the influence of a positive attitude towards life on the functioning of long-living persons. Material and methods: The research was conducted in Poland in 2017. Among the participants of the survey, there were 98 long-living women and men between 90 and 103 years of age, out of which 64,9% declared a positive attitude towards life, 27,8% - an indifferent attitude and 7,2% - a negative. The study was conducted with the use of a direct surveying method. The questionnaire consisted of instrumental activities of daily living (IADL) evaluation scale, basic activities of daily living (ADL) evaluation scale, Geriatric Depression Scale (GDS), pressure sore risk assessment scale (Norton) and a proprietary questionnaire. Results: The surveyed long-living persons mostly demonstrated good functionality, 74,5% among all the seniors proved themselves to be self-reliant in performing basic activities and 46,9% in instrumental activities. In both measurements of functionality in daily living, the seniors declaring a positive attitude towards life achieved higher scores than those with an indifferent and negative attitude. Attitude towards life very clearly differentiated the surveyed seniors with regard to aggravation of symptoms of depression. A moderate aggravation of depression was demonstrated by 34,4% seniors with a positive attitude and 47% with a negative attitude, whereas a serious aggravation of the problem was characteristic of only 7,8% of the respondents from the first group and as much as 41% of the seniors from the second group. Conclusions: A positive attitude towards life has a beneficial influence on self-reliance; it reduces manifestations of depressive disorders and diminishes the risk of the development of pressure sores.

Fatuma Kotile is a Nursing College Professor in Minnesota USA and also work at Bethesda Health East Hospital in St Paul MN. Fatuma Kotile has experience and passion in cultural competency in nursing education and health site practices. Her practice model and teaching in cultural competency are based on Lininger‘s Transcultural Nursing Model. Her goal is to increase diversity within nursing programs and help the program to learn, understand, and accommodate nursing students’ with mental health issues. She also assists her Oromo community from East Africa to confront the reality of mental health through workshops and outreach activities. The workshop aim is to increase understanding of the meaning and expression of culture care for older Oromo women living in the United States. This information is a valuable tool for community nurses to understand the background of Oromo cultural health practices and their views about health and illness. In addition, she is also an advocate for healthcare cultural competency when assisting patients who undergo a mental health crisis. Lastly, Fatuma is an enthusiastic learner who strives to understand how members of the community cope and move past their difficulties through healthy dialogue and methodologies.

Older Oromo women who immigrated to the United States in the early 1990s have undergone several stressful life events including war, famine, acculturation, harsh cold climates, a new language barrier with English, and a variety of lifespan experiences alien from those in their native country, Ethiopia. Coping with these new stress triggers correlates with a high level of depressive symptoms that Oromo people call “sadness.” The purpose of this project is to create and disseminate a transcultural model of nursing practices in a community that aims to alleviate sadness among older Oromo women by promoting and fostering community building through means of healthy life choices in the midst of change. A praxis approach guided by Madeleine Leininger’s theory of culture care.

Biography: Eguchi Miki has Nursing Master, expertise in cognitive behavior therapy and psychiatry nursing passion in improving the health and wellbeing. In particular, she is studying programs against ruminants by using mindfulness.

Abstract: Purpose: The purpose of this study was to explain the effect of developed “Cognitive Behavior Group Therapy for Rumination (CBGT-R)”. Method: The subjects were ten psychiatry nurses. The program was conducted once every week for eight weeks. It took 30 minutes per session. The program consisted of “Psychological education” and “exercise of mindfulness mainly on breathing methods” there were five people per group. The homework was to perform the breathing method (for more than five minutes ) as much as possible in daily life and record the results. The outcome measures were recorded according to the Rosenberg Self-Esteem Scale (RSES), Profile of Mood States (POMS), Cognitive Bias Scale(CBS) and Negative Rumination Scale(NRS). A pre and post design was conducted with a single group of ten nurses. The measurement times were taken- before(T0), at four weeks (T1), at the end of the program(T2), after one months(T3), and three months(T4). The results were analyzed using Bonferroni's multiple comparison tests. Result: Rumination, self-esteem, cognitive bias and mood were all significantly improved after the program. Although the effects are shown from the early stage (four week) by programming, it was suggested that at eight weeks program was desirable to obtain better results. Conclusion: Rumination may affect the mood and cognition has been suggested. Decreases in rumination cause improvement in mood, cognitive bias, and self-esteem.

Robyn Lutz has been a nurse for 33 years. Her passion is in working with adolescents to unleash their positive potential and to provide them with holistic guidance in their health care journey. Her presentation is based on a randomized controlled trial which was conducted from 2010-2016 using Motivational Interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy in adolescents. “Motivational Interviewing Is a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller & Rollnick, 2013). This study was funded by The Family and Youth Services Bureau of the United States Health and Human Services Dept. The highly rated RCT study showed strong and sustained effects on reducing rapid repeat pregnancy and thus promoting healthy birth spacing.

Background: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low-income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic. OBJECTIVE: The impact of this program on rapid repeat pregnancies at 18 months after enrollment was evaluated. STUDY DESIGN: Five hundred ninety-eight adolescent females were enrolled from 7 obstetrics-gynecology clinics and 5 postpartum units of a large hospital system in a Midwestern city. Each participant was enrolled at least 28 weeks pregnant or less than 9 weeks post- partum. Each participant was randomized to either the Teen Options to Prevent Pregnancy intervention or a usual-care control condition. Blinded research staff contacted participants at 6 and 18 months to complete self-report surveys. Differences in outcomes between the intervention and control groups were assessed using ordinary least- squares regression RESULTS: There was an 18.1% absolute reduction in self-reported repeat pregnancy in the intervention group relative to the control group (20.5% vs 38.6%%; P < .001). There was a 13.7% absolute increase in self-reported long-acting reversible contraception use in the intervention group relative to the control group (40.2% vs 26.5%, P 1⁄4 .002). There was no evidence of harmful effects of the intervention on sexual risk behaviors, such as having sexual intercourse without a condom or greater number of partners. CONCLUSION: The Teen Options to Prevent Pregnancy program represents one of the few evidence-based interventions to reduce rapid repeat teen pregnancy. This relatively brief intervention may be a viable alternative to more time-intensive programs for adolescent mothers.

Dr. Avinash Kaur Rana Lecturer in National Institute of Nursing Education P.G.I.M.E.R

Introduction: Pregnancy in most women involves biomedical and psychological changes in the body, emotions and life of mother and fetus. The majority of pregnant women have uncomplicated and healthy outcome but sometimes complications arise due to medical conditions. Although only 10-30% of the mothers seen in antenatal period can be classified as high risk they account for 70-80% of perinatal mortality and morbidity. Depression during pregnancy has been associated with increased incidence of psychological and obstetrical complications. Current descriptive study was undertaken with the objective to assess prevalence of depression and its associated factors among antenatal and postnatal mothers, Nehru Hospital, PGIMER, Chandigarh. Using total enumeration technique 200 mothers (100 antenatal and postnatal mothers) were enrolled in the study. Tools used in this study were- Socio-demographic profile of participants.2) Standardized Edinburgh postnatal depression scale, 3) Antenatal and Postnatal depression risk factors questionnaire. The Edinburgh postnatal depression scale had 10 items with 4 options. A score of ≥10 indicated possible depression. Mothers who scored <10 do not have depression. The antenatal and post natal risk questionnaire has13 items, if subject score<24 then it indicates no associated risk factors for depression whereas score ≥ 24 indicates possible risk factors of depression. Result: The result of the present study revealed that majority of the antenatal 81%and postnatal mothers 89% were not having any depression. It was also observed that 95% antenatal and 89% postnatal mothers did not have any associated risk factors of depression.

Dale M. Hilty, Associate Professor, received his PhD in counseling psychology from Department of Psychology at the Ohio State University. He has published studies in the areas of psychology, sociology, and religion. Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences.

The purpose of this educational intervention study was to explore the relationship among Wooden's Competitive Greatness (Hilty, 2018) construct (i.e., being the best you can be when your best is needed, continuous self-improvement, appreciating difficult challenges), Self-Efficacy (Schwarzer & Jerusaslem, 1995), and Greenglass' et al. (1999) Proactive Coping, Reflective Coping, Strategic Planning, Emotional Support Seeking scales. Since 43% of new RNs leave their first job within three years (Goodman, 2016), exploring these variables may provide insight into turnover rates. BSN (N=68) traditional nursing students were divided into two groups using competitive greatness. Hypothesis: There would be a difference between competitive greatness high and low scoring groups when the two groups were compared using an Independent t-test on Self-Efficacy, Proactive Coping, Reflective Coping, Strategic Planning, Emotional Support Seeking scales ESS scales. Using SPSS 25, the coefficient alpha were Self-Efficacy (.957), Proactive Coping (.816), Reflective Coping (.909), Strategic Planning (.866), and Emotional Support Seeking (.854). Independent t-test (N=68) analysis found significant differences between the two participant groups for the Self-Efficacy (p=.002), Proactive Coping (p=.001), Reflective Coping (p=.008), Strategic Planning (p=.004), and Emotional Support Seeking (p=.028) scales.

Dale M. Hilty, Associate Professor, received his PhD in counseling psychology from Department of Psychology at the Ohio State University. He has published studies in the areas of psychology, sociology, and religion. Between April 2017 and April 2018, his ten research teams published 55 posters at local, state, regional, national, and international nursing conferences. His colleague sharing the author line of this poster is Aimee Shea, MPH, RDN, CSO, LD.

At our undergraduate nursing institution, faculty are encouraged to develop interprofessional curricula. As psychology and nutrition faculty, we designed a program to integrate nutrition, statistics, and psychological decision-making. First, undergraduate students demonstrated a limited understanding of how dietary manipulation impacts overall nutrient consumption. A 30-minute presentation highlighted how variability in meal selection impacted the daily recommendations for calories, fiber, sodium, protein, saturated fat, and added sugar. Second, student healthy and unhealthy food decision-making appeared to be associated with conflict management styles. We were interested in exploring intrapersonal and interpersonal conflict styles in relation to dietary choices. Participants were traditional nursing students (56 freshman, 78 sophomore), and 58 nursing students in the accelerated program. They completed the intrapersonal food choices questionnaire (IFCQ) and the interpersonal conflict handling styles questionnaire (ICHS); (Leung & Kim, 2007). The IFCQ is an adaption of the ICHS reflecting conflict between healthy and unhealthy food choices. The second year students (N=76) and the accelerated (SDAP, N=53) students completed the IFCQ and ICHS as comparison groups designed to replicate the intrapersonal and interpersonal findings from the first year students. Cox (2003) reports the importance of intrapersonal and interpersonal comparisons. Quantitative & Qualitative Results: (1) the analysis of the cognitive knowledge pre-post questions found the 30-minute intervention was significant (dependent t-test, p=.001); (2) qualitative theme analysis (based on open-ended questions) revealed meaning, relevancy to nursing practice; and (3) the interdisciplinary team reported experiential learning. Correlational significance (p<.01) was found for four interpersonal/intrapersonal conflict types (i.e., compromising, integrating, obliging, avoiding/smoothing).

Monika Dudová is a PhD. student at Charles University in Prague, the Czech Republic. In her postgraduate study she is focused on mental health and work with people with mental disorders, and in her dissertation she examines the evaluation of the psychiatric reform from the view of the community services users. Moreover she is a systematic psychotherapist and in her own praxis the focuses on adult population, mainly adults with experiences with anxiety disorder and other psychiatric difficulties. Currently, she works as a researcher in a project called KREAS – A creativity and adaptability as a prerequisite for Europe's success in an interconnected world.

Statement of problem: Since 2013 there has been an ongoing transformation of psychiatric care in the Czech Republic. Psychiatry care should stand on 4 pillars: psychiatry hospitals, where the number of beds is being reduced, psychiatry departments in general hospitals, outpatient departments and new loew-trashold pillar – Mental Health Care Centres (MHC). The core of MHC is a multidisciplinary team consisted of psychiatrist, psychologists, peer worker(s), psychiatric nurses and social workers. Findings: The research was taking place during the launching of the pilot MHC projects. The multidisciplinarity brings new views on providing care to people with SMI. The results showed that the overlapping of competencies in MHC is no an issue. However sharing, looking into the health or social databases, giving medication, inssufficient salaries for professionals or nonexisting network of the other community mental health services were marked as the problematic areas. The obstacles, risky for the optimal function of the team, are caused by the legislative definition of psychiatric nurses´and social workers´competencies. Conclusion & Significance: The existing definition of competencies of professionals, mainly psychiatric nurses and social workers, is not corresponding with the needs of community oriented mental health services in MHC. The transition from institutionalized care to a community environment needs different education of psychiatric nurses, who should learn the methods of the social work, community work or case management. Social workers should be educated in areas of psychopathology, psychopharmacology or crisis intervention. The new form of care of SMI in community conditions brings a new formo f cooperation between the professionals, contributes to the destigmatization of the people with mental disorders and psychiatry in general. The deinstitucionalization and transformation of psychiatric care is aimed at improving quality of psychiatry services and increasing the full-fledged inclusion of people with mental disorders into society.

Karin J D Bulik is a graduate psychologist from UFRN, Brazil. She holds an MSc degree in Mental Health and Transcultural Mental Healthcare from the Queen Mary University of London, the UK, and an MSc degree in Psychology, Society, and Quality of Life from UFRN, Brazil. She is also postgraduate in Public Health from Castelo Branco University, Brazil. She studies and works on the following topics: mental health, global mental health, psychoanalysis, and psychopathology. She is a Psychology professor at University Center Uniface, leading the disciplines of Mental Health and Psychoanalysis and supervising graduate students in their placements. She also works as a psychologist at the Psychiatric Hospital Dr. João Machado, where she is the Psychology team coordinator, and in private practice as a psychoanalyst.

Statement of the problem: Mental health services in Brazil are usually neglected by the government and the economic crisis in the country has made this problem more evident. There is a shortage of professionals, medicines and other hospital supplies in the public hospitals. In the psychiatric hospital where the author works as a psychologist this has made the number of invasive practices increase, as chemical and mechanical restraint, which should be used in very specific cases; and the number f therapeutic practices such as expressive groups, occupational therapy, and art therapy, decrease. The purpose of this study is to highlight what literature has presented as benefits of therapeutic practices in mental health and to relate them with the experiences lived in the hospital. Methodology and Theoretical Orientation: A literature review of articles containing the keywords mental health and therapeutic practices (and synonyms) was conducted. Results were linked with examples collected from everyday experience in the hospital. Findings: Literature has shown the use of therapeutic activities as beneficial in the work with people with mental disorders: positive changes in worry, depression, sense of loneliness and negative thinking, improvements in self-esteem, empowerment, confidence, concentration, sense of time, use of imagination, sense of satisfaction and social functioning are reported. The lack of these activities results in a greater number of episodes of aggression decreased autonomy and greater delay in recovery. The daily practice in the hospital endorses these findings. Conclusion and Significance: Although health treatment in Brazil is mostly based on the medical paradigm, this study stresses the importance of expressive therapeutic practices, decreasing the length of stay and improving recovery of inpatients. It contributes to the call for more public health attention regarding the benefits of multi-professional interventions in mental health care.