Journal of Psychosocial Nursing and Mental Health Services
Vol. 46 No. 4 April 2008
Reducing HIV Risk Among People With Serious Mental Illness
Janyce G. Dyer, PhD, CRNP, CS; and Teena M. McGuinness, PhD, PMH-NP, BC
ABSTRACT
The rate of HIV infection among U.S. citizens who live with serious mental illness (SMI) is significantly higher than among the general population. Research on the determinants of risk behavior is limited. The purpose of this article is to explore the effects of HIV- related health disparities on people with SMI by analyzing the multiple determinants, or domains of risk, and describing issues related to tailoring HIV primary prevention risk reduction strategies to people with SMI. According to the model proposed by Meade and Sikkema, domains of risk include psychiatric illness, substance use, cognitive-behavioral factors, social relationships, and demographics. The majority of people with SMI are sexually active and engage in behaviors that place them at high risk for HIV/AIDS. Mental illness may affect HIV risk through interacting domains that influence sexual behavior. HIV risk reduction strategies must consider psychiatric illness and comorbidities, social relationships, and trauma history. In addition, these efforts should be integrated into existing services.
AUTHORS
Dr. Dyer is Professor, University of Alabama, Capstone College of Nursing, Tuscaloosa, and Dr. McGuinness is Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Janyce G. Dyer, PhD, CRNP, CS, Professor, University of Alabama, Capstone College of Nursing, Box 870358, 407 Russell Hall, Tuscaloosa, AL 35487-0358; e-mail: jgdyer@bama.ua.edu.
Metaphors of a Shifting Sense of Self in Men Recovering from Substance Abuse and Suicidal Behavior
Stian Biong, RN, MPH; Bengt Karlsson, RN, PhD; and Tommy Svensson, PhD
ABSTRACT
The purpose of this descriptive study was to explore and interpret men’s experience of sense of self within the context of recovery from substance abuse and suicidal behavior. A secondary analysis of data from a previous study of four young Norwegian men revealed how a shifting sense of self was constructed through the use of metaphors. The analysis identified three themes related to the participants’ sense of self: The Meaning of Being Isolated, The Meaning of Being Close to the Point of No Return, and The Meaning of Still Being on the Edge. By acknowledging metaphorical expressions as a source of important knowledge, this study reflects on how mental health professionals can use metaphors in the recovery process. As part of the treatment alliance and therapeutic communication, we suggest that metaphors may aid the assessment of suicidal ideation, promote a sense of a more active self, and signal acceptance and recognition of subjectivity.
AUTHORS
Mr. Biong is a DrPH student, Nordic School of Public Health, Göteborg, Sweden; Dr. Karlsson is Associate Professor, Department of Health Sciences, Buskerud University College, Drammen, Norway; and Dr. Svensson is Professor, Nordic School of Public Health, Göteborg, Sweden, and Professor, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Stian Biong, RN, MPH, Nordic School of Public Health, Box 12133, 402 042 Göteborg, Sweden; e-mail: stian.biong@nhv.se.
What Is the Role of e-Technology in Mental Health Services and Psychiatric Research?
Michelle Cleary, RN, BHlthSc(Nurs.), MHlthSc(Nurs.), PhD; Garry Walter, MB BS, BMedSc, PhD, FRANZCP; and
Sandra Matheson, BSc(Hons.)
ABSTRACT
In this article, the role of e-technology is explored, with an emphasis on the advantages and disadvantages of its use for health care and mental health research. E-technology is broadly understood to include the Internet and related information technologies, and in recent years, its use has grown rapidly. The Internet is a major source of health information, and there is potential to deliver enhanced services through this medium. In addition, e-technology’s role in future mental health service delivery and research will continue to expand as increased numbers of consumers, caregivers, health professionals, and the general population go online, particularly as the technology is refined and made even more user friendly.
AUTHORS
Dr. Cleary is Clinical Associate Professor of Mental Health, Faculty of Nursing and Midwifery, University of Sydney, and Clinical Nurse Consultant, Research Unit, Sydney South West Area Mental Health Service; Dr. Walter is Professor of Child and Adolescent Psychiatry, University of Sydney, and Area Clinical Director, Child and Adolescent Mental Health Services, Northern Sydney Central Coast Health; and Ms. Matheson is Research Officer, Research Unit, Sydney South West Area Mental Health Service, Sydney, New South Wales, Australia.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. The paper on which this article is based was supported by an Educational Grant from Janssen-Cilag.
The authors thank Tracey Davenport and Georgina Luscombe for their initial contribution to the development of the article.
Address correspondence to Michelle Cleary, RN, BHlthSc(Nurs.), MHlthSc(Nurs.), PhD, Clinical Nurse Consultant, Research Unit, Sydney South West Area Mental Health Service, PO Box 1, Rozelle, New South Wales, 2039, Australia; e-mail: michelle.cleary@email.cs.nsw.gov.au.
