Community Mental Health Nursing
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Browsing Community Mental Health Nursing by Author "Dr. Sabrina Russo"
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- ItemAssociation between Autism and Iron Deficiency in Autistic Children in the Northern West Bank(2013) Sajed Faisal Al Ali; Dr. Aidah Abu Elsoud Alkaissi; Dr. Sabrina RussoBackground: Iron has an important role in cognitive, behavioral, and motor development. A high prevalence of iron deficiency (ID) has been reported in people with autism. Children with autism are at risk for ID and this condition may increase the severity of psychomotor and behavioral problems, some of which already inherently exist in these children. Aim: The aim of this study is to investigate the association between autism and iron deficiency in autistic children in the northern West Bank and to identify food selectivity and compare indices of food selectivity among children with autism, children with mental disorders and typically developing children (normal children). Participant and Methods: 90 children with an age range of 3 to 13 years participated in a case control study distributed into study group and two control groups. Thirty children diagnosed with autism according to DSM-IV and ICD-10criteria served as a study group, 30 children with mental disorders other than autism served as a control group, and 30 typically developing children taken from the public functioned as a second control group. The three groups were matched for age, gender and geographical area. Serum ferritin, hemoglobin, hematocrit, mean corpuscular volume, and red cell distribution width values were measured and analyzed with food habit survey and demographic data. Results: ID was detected in 20% (N = 6/30) of autistic children based on Serum ferritin level (SF< 10µ/l), compared with 0% for the two control groups (p= 0.0001). Anemia was defined as hemoglobin <110g/l for children under the age of 6 years and hemoglobin <120g/l for children between 6 and 13 years of age .When analysis done for HGB to these six children (children who have low serum ferritin); it was found that 66.6% (4/6) of the children two were pre-school male children (HGB is less than 110g/1), and the other two were one male and one female of school children (HGB is less than 120g/l) have iron deficiency anemia, and the iron deficiency anemia was 13.3% (4\30) for all autistic group. The results indicated that these differences were for males. It was found also that the frequency of low iron intake in these children was associated with feeding difficulties and food selectivity; there was a significant difference between children in the autistic group who chose foods with a red color as a favorite 23% (7/30) compared to the other two control groups: 0%, respectively (p= 0.0001). The results demonstrated also a significant difference in the frequency of snacks per day (≥ 4) in autistic children 40% (12/30) compared to both mental disorder 16.7 % (n = 5/30) (p = 0.006) and typically developing children 6.7% (n = 2/30) groups (p = 0.001). Conclusion: Results of this study indicated that there is an association between autism, iron deficiency and anemia. Low levels of serum ferritin in autistic children might be a sign of iron deficiency and an early precursor of iron deficiency anemia. These findings suggest that food selectivity is more common in children with autism than in typically developing children. These findings suggest that ferritin levels should be measured in children with autism as a part of routine investigation. Keywords: Child, Autism, Mental disorder, typically developing children, Iron deficiency, Iron deficiency anemia, Ferritin.
- ItemThe Experience of Palestinian Children Facing Traumatic Events The Case of a Village under Military Occupation: A Descriptive Phenomenological Study(2016) Farid Abu Liel; Dr. Sabrina RussoIntroduction: The objective of this research is to provide an overview of the effects of war and living in a conflict zone on children; to capture their lived experience facing traumatic events and to explore the phenomenological experience of those children who live in a village nearby an Israeli settlement and separation wall, under a daily struggle against the Israeli occupation. The research seeks to understand the effect of trauma on children who live in a violent environment in order to understand the impact of such traumatic events on them, and to explore their feelings and thoughts. Aim: The aim of this study is to investigate and describe the experience of Palestinian children facing daily traumatic events. It is also our concern to understand how these children are psychologically affected by their experience. Military occupation poses a challenge for the mental health of children in Palestine, and it is influenced by a set of complex and interactive individual, social, cultural, and economic factors. Lack of studies in such issues makes it difficult to understand the phenomena in relation to the special cultural and social aspects in Palestine. Understanding these factors is critical in provision of effective and culturally appropriate care. We will employ a qualitative approach in order to create a rich and deep understanding of this important issue. Design: The design used is a qualitative phenomenological descriptive design. This design is used to study and to explore the lived experience of the Palestinian children who face traumatic events by describing the aspect of this experience and by focusing on what exists. Sample: Purposive sampling was used; 15 children who lived in a Palestinian village under military occupation and experiencing settler attacks. Setting: Interviews were conducted in a private room in the respondent’s house. Data Analysis: The data was analyzed by using Giorgi’s phenomenological psychology method (1985). Results: Three major themes emerged from the children’s interviews and ten sub-themes; (1) Exposure to Traumatic Events (Life threatening, witnessing violence, direct violence, deprivation of freedom, lack of safety and fear); (2) Normalization (1Role playing the traumatic events, Underestimation of danger); (3) Resilience (self-efficacy, 2Awareness and belonging, and trust in adults). Conclusion: The findings of the study demonstrate the importance of understanding the experience of the Palestinian children facing traumatic events. It reflects how these children face the traumatic events regarding the military and settler actions in their village, how they react to these events, and the degree to which they are affected. The children normalized the events through role playing the trauma and acting out violence and underestimation of danger, but then demonstrated resiliency that allowed them to increase their courage to continue. Key words: Phenomenology, trauma, children, war
- ItemNurses’ Attitudes and Practices towards Inpatient Aggression in Dr. Kamal Mental Health Hospital(2014) Hussein Al- Awawdeh; Dr. AidahAlkaissi; Dr. Sabrina RussoBackground: Inpatient aggression can occur for many reasons and there are many factors that contribute to this occurrence such as patient factors, staff factors and environmental factors. There are strategies to prevent and manage aggression. Aims: The aims of this study are to explore nurse's practices and attitudes of inpatient psychiatric aggression to identify the way the nurses handle aggression by patients and exploring the effects of patients, staff and environmental factors on the occurrence of aggression. Participants and methods: The study was conducted at Dr. Kamal Adwan Psychiatric Hospital in Bethlehem. All nursing staff in the mental health hospital who had worked for at least one year at the time of the study were recruited (67 nurses). The participants ranged in age from 20-50 years with a mean age of (35.1) (±SD = ±7.8) and included 30 females and 37 males. A questionnaire was used which has three scales: Attitude Toward Aggression Scale (ATAS), Management Of Aggression and Violence Scale (MAVAS) and Demographic Scale. Results: Nurses were inclined to perceive patient aggression as destructive, violent, intrusive and functional reactions. They were less inclined to view aggression as protective, communicative or acceptable normal reactions. Female nurses in this study were more likely to view aggression as having an intrusive role whereas, on the contrary, male nurses were more likely to view aggression as having a communicative role and they believed that the aggression could be managed in general. Longer professional experience was significantly associated with a higher frequency of the management of aggression in general. Nurses from the admission ward (male and female) were in less agreement with the Protective and Communicative Attitudes scales than the nurses from the other inpatient wards. On the other hand, nurses from admission ward (particularly female) and recovery ward (male and female) had a higher rate of violent and offensive reaction to aggression than nurses from the other wards. The nurses from the chronic female ward had a higher intrusive scale than nurses from the other wards. The highest level of the scientific grade group is a Master of Mental Health with a high level mean regarding the attitudes to the acceptable normal reaction scale, violent reaction scale, functional reaction scale, offensive scale, communicative scale, destructive scale, external causative factors scale, situational/interactional causative factors scale, Management: general, and Management: use of medication. The nurses agree that there are internal, external and interactional factors to inpatient aggression. Nurses believe that patients may be aggressive because of the environment of the psychiatric hospital. Nurses believe that aggression develops because staff do not listen to the patients, there is poor interaction between staff and patients and other people make patients aggressive. Nurses believe in the use of medications, restraint and seclusion widely , on the contrary, they believe in the use of non-physical methods like negotiation and expression of anger. Conclusion: This study demonstrate that there are different attitudes of nurses toward patient aggression in psychiatric inpatient settings. This study found that aggression is negatively viewed by Palestinian psychiatric nurses. These attitudes are reflective of the opinions of lay persons in our society. There is a need for training programs to reorient the opinions of nurses in relation to inpatient aggression. These programs should contribute to improved patient care and reduction in the frequency of aggressive acts within inpatient units. Key words: Aggression; mental health nurses; ATAS; MAVAS
- ItemPalestinian Women Attempted Suicide, Risks beyond the Experience A Descriptive Phenomenological Study(2014) Einas Abu Safa; Dr. Aidah Alkaissi; Dr. Sabrina RussoIntroduction: suicide is a major public health problem all over the world. It described as “intentional, self-destructive, and self-inflicted acts. Aim: The aim of this study is to explore the risks beyond the experience of attempting suicide among a group of Palestinian women. Design: The study used a qualitative descriptive phenomenological method to explore the experiences of Palestinian women attempted suicide, to capture as much as possible the way in which the phenomenon is experienced, and the risks lays beyond the experience. Data collection: Face to face, in-depth, semi-structured interviews were conducted with participants – the women who previously attempted suicide. Sample: Purposive sampling was used; 20 women attempted suicide at least once. Setting: Interviews were conducted in a private place agreed for with the women. Data Analysis: The data was analyzed by using Giorgi’s phenomenological psychology method (1985). Results: From the interviews, Five themes and eighteen sub-themes emerged: violence (Sexual violence, domestic violence, collective violence, witnessing abuse, and child maltreatment); Losses (loss of parents, loss of cultural identity, loss of relation, and loss of security) ; psychological risk factors (Low self efficacy, Low Self esteem, Negative Self image, and Maladaptive coping mechanism); and Socio cultural factors (poverty, stigma, and dysfunctional family); Lack of support system (Non professional, and professional). Conclusion and Recommendation: The findings of the study demonstrate the importance of understanding the experience of the women attempted suicide, the risk beyond their experience, and the phenomena of suicide within the Palestinian community. It reflect the need for national prevention programs which include the implementation of national programs for mental health, recognizing the rights of females, tackling illiteracy among both males and females, prohibiting forced child marriage, providing economic and social support especially for young females, and promoting Islamic values rather than traditional customs. Key words: Attempted suicide, experience, risk, descriptive phenomenology. Definitions of Concepts: - Violence: is the intentional use of physical force or power, threatened or actual, against a person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation. This definition associate intentionality with the committing of the act itself, irrespective of the outcome it produces (WHO, 2005). - Sexual violence: any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work(WHO, 2005). - Rape: Physically forced or otherwise coerced penetration even if slight – of the vulva or anus, using a penis, other body parts or an object(WHO, 2005). - Domestic violence: refers to a behavior by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, and psychological abuse and controlling behaviors (WHO, 2005). - Physical abuse: is an act of another party involving contact intended to cause feelings of physical pain, injury, or other physical suffering or bodily harm (WHO, 2005).
- ItemPrevalence and Severity of Depression among Mothers of Disabled Children in Palestine(2015) Nemer Ahamd Nemer Hamamreh; ; Dr. Aidah Alkaissi; Dr. Sabrina RussoIntroduction: Mothers of children with disabilities often experience greater stress and emotional demands than other mothers do. Mothers of children with disabilities showed also more psychological distress than other member in their families, as they are the primary caregivers for their children. Childhood disability often imposes a social and emotional burden for children and their families. Aim: The aim of the study is to assess the prevalence and severity of depression among mothers of disabled children in the north of the West Bank in order to establish baseline data and suggest recommendations to policy makers and professional workers. Subject and Methods: A descriptive, analytical kind (cross sectional) study. About 200 mothers were included in the study divided in two groups, including 100 mothers of children with disabilities (age range, 2-16years) as a study group, and 100 mothers of normally developing children (age range, 2-16 years) as a control group. There were 47% girls and 53% boys in the children of the control group and there were 38% girls and 62% boys in the children of the study group . These children have different diagnoses with a 10% down syndrome, 18% hearing disabilities, 7 % physical disability, 11% speech disorders, 18% autism, 14% mental retardation, 12% cerebral palsy and 10 % other disorder The mothers’ average ages in the study group and control group were 32.6 (SD±6.3) and 31(SD± 5.7) years, respectively. A demographic information form and Beck Depression Inventory were administered to mothers of these children who met the inclusion criteria. The assessments were performed during children´s treatment in rehabilitation centers. Result: The prevalence of depression was higher among mothers caring for disabled children than mothers of non-disabled children in the control group. Fifty four percent of mothers of disabled children had a mild to severe level of depression and 18% of the them suffered from moderate to severe depression as derived from Beck Inventory score. When we compare between the study and control groups, the study reveals that there are many factors that increase the prevalence of depression among mothers in the study group compared to control group which include: child’s age <10 years, mother’s age <40 years, middle and low income, and un-employment.