nursing research topics on mental health

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35+ Research Topics on Mental Health Nursing: Fostering Wellbeing in Psychiatric Care

Carla johnson.

• August 24, 2023
• Essay Topics and Ideas

Mental health nursing is a critical pillar in nurturing the overall wellness of individuals grappling with psychiatric conditions. Aspiring nursing students, comprehending the nuances of mental health nursing is not only pivotal for your academic voyage but also your future professional practice. In this comprehensive guide, we delve profoundly into mental health nursing. We will explore a range of PICOT questions, propose ideas for evidence-based practice (EBP) projects, furnish you with capstone project ideas, offer a spectrum of research paper topics, present a compilation of research questions, and provide several essay topic concepts. All these facets are intended to equip you holistically for this indispensable domain.

What You'll Learn

Understanding the Essence of Mental Health Nursing

Mental health nursing entails the compassionate care and unwavering support extended to individuals traversing the challenges of mental health issues. The role of a mental health nurse transcends the confines of conventional medical care , encompassing therapeutic communication, emotional bolstering, and fostering an environment conducive to healing. Mental health nurses operate in a myriad of settings including hospitals, community health centers, and outpatient clinics, playing an instrumental role in shaping the lives of their patients.

PICOT Questions on Mental Health Nursing

• Population (P): Adults under psychiatric care ; Intervention (I): Integration of daily RS questionnaire; Comparison (C): Units without daily survey; Outcome (O): Decreased employment of restraint and seclusion; Time (T): 6 months. How does the incorporation of a daily RS (Restraint and Seclusion) questionnaire for adults in psychiatric care, compared to units lacking this daily survey, impact the reduction in the utilization of restraint and seclusion for 6 months?
• P: Adolescents with depressive disorders ; I: Implementation of mindfulness-based intervention; C: Standard therapeutic approach; O: Mitigation of depressive symptoms; T: 8 weeks. Among adolescents diagnosed with depressive disorders, what is the effect of incorporating a mindfulness-based intervention, compared to standard therapy, on alleviating depressive symptoms over an 8-week period?
• P: Elderly residents in long-term care facilities; I: Deployment of pet therapy ; C: Absence of pet therapy; O: Enhancement of mood and social interaction; T: 3 months. In elderly individuals residing within long-term care facilities, does the introduction of pet therapy, as opposed to its absence, result in a noticeable improvement in mood and social interaction over a course of 3 months?
• P: Individuals grappling with schizophrenia ; I: Integration of family psychoeducation; C: Standard care regimen; O: Diminished recurrence rate of episodes; T: 1 year. For individuals diagnosed with schizophrenia, does the inclusion of family psychoeducation within their treatment plan, when compared to standard care, lead to a reduction in the frequency of relapses over a 1-year period?
• P: Veterans afflicted with post-traumatic stress disorder (PTSD); I: Employment of virtual reality exposure therapy; C: Conventional therapeutic methods; O: Reduction in symptoms of PTSD; T: 10 sessions. In veterans struggling with post-traumatic stress disorder (PTSD), does the utilization of virtual reality exposure therapy result in a more pronounced reduction in PTSD symptoms, when contrasted with conventional therapy, across a span of 10 sessions?
• P: Children diagnosed with autism spectrum disorder (ASD); I: Incorporation of equine-assisted therapy; C: Standard interventions; O: Amplification of social skills; T: 12 weeks. Among children with autism spectrum disorder (ASD), does participation in equine-assisted therapy yield an advancement in social skills, in comparison to standard interventions, over a duration of 12 weeks?
• P: Inpatient populace with bipolar disorder ; I: Introduction of a mood tracking application; C: Conventional mood charting techniques; O: Attainment of superior mood stability; T: 6 months. Within inpatients diagnosed with bipolar disorder, does the utilization of a mood tracking application for monitoring moods contribute to enhanced mood stability in comparison to conventional mood charting over a span of 6 months?
• P: Individuals contending with eating disorders; I: Application of cognitive-behavioral therapy (CBT); C: Provision of supportive counseling; O: Reduction in maladaptive eating behaviors; T: 16 sessions. For individuals grappling with eating disorders, does the implementation of cognitive-behavioral therapy (CBT) yield a more substantial reduction in maladaptive eating behaviors, when contrasted with supportive counseling, over 16 sessions?
• P: Patients undergoing substance abuse treatment; I: Integration of music therapy; C: Absence of music therapy; O: Mitigation of anxiety and cravings; T: 8 weeks. Among patients undergoing substance abuse treatment, does engagement in music therapy contribute to a reduction in anxiety and cravings, in comparison to those without exposure to music therapy, over a duration of 8 weeks?
• P: Senior residents of assisted living facilities; I: Implementation of reminiscence therapy; C: Participation in routine activities; O: Elevation in cognitive functioning; T: 3 months.

In senior individuals residing in assisted living facilities, does involvement in reminiscence therapy lead to an improvement in cognitive functioning when juxtaposed with engagement in routine activities across a span of 3 months?

5 EBP Projects on Mental Health Nursing

• Appraising the Efficacy of Art Therapy in Alleviating Anxiety Among Schizophrenia Patients.
• Probing the Influence of Exercise Interventions on Bipolar Disorder Patients’ Depressive Symptoms.
• Unpacking Aromatherapy’s Role in Managing Agitation Among Dementia Patients.
• Evaluating Peer Support Groups’ Contribution to Borderline Personality Disorder Recovery.
• Analyzing Virtual Support Networks’ Role in Mitigating Adolescent Social Anxiety Isolation.

Engaging Capstone Projects on Mental Health Nursing

• Forging a Mental Health Awareness Campaign to Combat Stigma Surrounding Help-Seeking in High Schools.
• Devising an Inclusive Training Module for Nurses Enhancing Communication with Psychosis Patients.
• Crafting a Manual to Empower Families in Supporting Loved Ones with Obsessive-Compulsive Disorder (OCD).
• Establishing a Mindfulness Program for Psychiatric Hospital Personnel to Counter Burnout.
• Designing a Transitional Care Blueprint for Smooth Community Reintegration of Severe Mental Illness Patients Post-Hospitalization.

Research Paper Topics on Mental Health Nursing

• Examining the Role of Trauma-Informed Care in Enhancing Recovery for Domestic Violence Survivors with PTSD.
• Delving into the Nexus Between Childhood Trauma and the Emergence of Dissociative Identity Disorder.
• Surveying the Impact of Sleep Quality on College Students’ Mental Health : A Systematic Review.
• Assessing Telepsychiatry’s Efficacy in Extending Mental Health Services to Rural Regions.
• Navigating Cultural Competency in the Assessment and Treatment of Diverse Depression Patients.

Mental Health Nursing Research Questions

• How Does Early Intervention in Childhood Emotional Dysregulation Shape Mood Disorder Onset in Adulthood?
• What Are the Challenges to Adherence to Medication Among Schizophrenia Patients, and How Can Nursing Strategies Address Them?
• What Is the Impact of Mindfulness-Based Stress Reduction Initiatives on Psychiatric Nurses’ Stress Levels?
• What Factors Contribute to the Overrepresentation of Marginalized Individuals with Coexisting Mental Illness in the Criminal Justice System?
• What Are the Long-Term Effects of Electroconvulsive Therapy (ECT) on Memory and Cognitive Function in Severe Depression Patients?

Essay Topic Ideas & Examples

• Ethical Conundrums in Administering Electroconvulsive Therapy (ECT).
• Exploring the Nexus Between Trauma and Substance Abuse in Individuals with Dual Diagnoses.
• Nurses’ Role in Preventing Suicides: Assessing Risk and Providing Support.
• Cultural Proficiency in Mental Health Nursing: Catering to Multifaceted Patient Requirements.
• COVID-19’s Ripples on Healthcare Providers’ Mental Health: Coping Strategies Amid Challenges.

As you immerse yourself in the tapestry of mental health nursing, myriad opportunities unfold for your contributions to research, evidence-based practices, and compassionate patient care. These PICOT questions, EBP project suggestions, capstone project proposals, research paper topics, research questions, and essay themes constitute the foundation of your journey. Each endeavor you undertake to deepen your comprehension and skills in mental health nursing brings you closer to making a profound difference in the lives entrusted to your care. Should you need additional guidance when crafting essays, research papers, or any scholastic composition related to nursing and mental health, do not hesitate to seek professional aid. Our writing services are tailored to support your academic growth and triumph, ensuring your valuable contributions to mental health nursing are eloquently conveyed and impactful.

• What are the 4 principles of mental health nursing?

The four principles of mental health nursing are: therapeutic relationships, holistic care, patient-centeredness, and evidence-based practice. These principles guide nurses in providing comprehensive and effective care to individuals with mental health conditions.

• What is the role of a nurse in mental health treatment?

Nurses in mental health treatment play a pivotal role in assessing, planning, implementing, and evaluating care for patients with mental health issues. They provide therapeutic support, administer medications, conduct psychoeducation, and collaborate with the multidisciplinary team to promote recovery.

• What are the different types of mental health nurses?

Different types of mental health nurses include psychiatric-mental health nurses, advanced practice psychiatric nurses, child and adolescent mental health nurses, and geriatric mental health nurses. These specialized nurses cater to diverse patient populations and address specific mental health challenges.

• What are the 6 C’s in mental health nursing?

The 6 C’s in mental health nursing stand for Care, Compassion, Competence, Communication, Courage, and Commitment. These core values guide mental health nurses in delivering compassionate and effective care to individuals facing mental health issues.

Mental health nursing stands as a critical pillar in nurturing the overall wellness of individuals grappling with psychiatric conditions. Aspiring nursing students, comprehending the nuances of mental health nursing is not only pivotal for your academic voyage but also for your future professional practice. In this comprehensive guide, we delve profoundly into the realm of mental health nursing. We will explore a range of PICOT questions, propose ideas for evidence-based practice (EBP) projects, furnish you with capstone project ideas, offer a spectrum of research paper topics, present a compilation of research questions, and provide a plethora of essay topic concepts. All these facets are intended to equip you holistically for this indispensable domain.

Mental health nursing entails the compassionate care and unwavering support extended to individuals traversing the challenges of mental health issues. The role of a mental health nurse transcends the confines of conventional medical care, encompassing therapeutic communication, emotional bolstering, and fostering an environment conducive to healing. Mental health nurses operate in a myriad of settings including hospitals, community health centers, and outpatient clinics, playing an instrumental role in shaping the lives of their patients.

• Population (P): Adults under psychiatric care; Intervention (I): Integration of daily RS questionnaire; Comparison (C): Units without daily survey; Outcome (O): Decreased employment of restraint and seclusion; Time (T): 6 months. How does the incorporation of a daily RS (Restraint and Seclusion) questionnaire for adults in psychiatric care, compared to units lacking this daily survey, impact the reduction in the utilization of restraint and seclusion over a span of 6 months?
• P: Adolescents with depressive disorders; I: Implementation of mindfulness-based intervention; C: Standard therapeutic approach; O: Mitigation of depressive symptoms; T: 8 weeks. Among adolescents diagnosed with depressive disorders, what is the effect of incorporating a mindfulness-based intervention, in comparison to standard therapy, on the alleviation of depressive symptoms over an 8-week period?
• P: Elderly residents in long-term care facilities; I: Deployment of pet therapy; C: Absence of pet therapy; O: Enhancement of mood and social interaction; T: 3 months. In elderly individuals residing within long-term care facilities, does the introduction of pet therapy, as opposed to its absence, result in a noticeable improvement in mood and social interaction over a course of 3 months?
• P: Individuals grappling with schizophrenia; I: Integration of family psychoeducation; C: Standard care regimen; O: Diminished recurrence rate of episodes; T: 1 year. For individuals diagnosed with schizophrenia, does the inclusion of family psychoeducation within their treatment plan, when compared to standard care, lead to a reduction in the frequency of relapses over a 1-year period?
• P: Inpatient populace with bipolar disorder; I: Introduction of a mood tracking application; C: Conventional mood charting techniques; O: Attainment of superior mood stability; T: 6 months. Within inpatients diagnosed with bipolar disorder, does the utilization of a mood tracking application for monitoring moods contribute to enhanced mood stability in comparison to conventional mood charting over a span of 6 months?
• Surveying the Impact of Sleep Quality on College Students’ Mental Health: A Systematic Review.

As you immerse yourself in the tapestry of mental health nursing, myriad opportunities unfold for your contributions to research, evidence-based practices, and compassionate patient care. These PICOT questions, EBP project suggestions, capstone project proposals, research paper topics, research questions, and essay themes constitute the foundation of your journey. Each endeavor you undertake to deepen your comprehension and skills in mental health nursing brings you closer to making a profound difference in the lives entrusted to your care. Should you find yourself in need of additional guidance when crafting essays, research papers, or any scholastic composition related to nursing and mental health, do not hesitate to seek professional aid. Our writing services are tailored to support your academic growth and triumph, ensuring your valuable contributions to the realm of mental health nursing are eloquently conveyed and impactful.

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Psychiatric-Mental Health Nursing Research Paper Topics

This page provides a comprehensive list of psychiatric-mental health nursing research paper topics , which serves as a crucial resource for nursing students assigned to write research papers. The field of psychiatric-mental health nursing is vast, encompassing a wide variety of topics related to mental health care. This extensive list has been carefully curated to include a diverse range of topics divided into ten distinct categories, making it easier for students to find a subject of interest and relevance to their studies. In addition to the list of topics, the page also includes a detailed article discussing the significance of psychiatric-mental health nursing and the various aspects it covers. Additionally, the page offers information on iResearchNet’s writing services, providing an opportunity for students to order custom-written research papers if needed. Ultimately, this page serves as a one-stop resource for students, aiding them in selecting a topic, understanding the importance of psychiatric-mental health nursing, and, if necessary, ordering a custom research paper.

100 Psychiatric-Mental Health Nursing Research Paper Topics

The field of psychiatric-mental health nursing is incredibly diverse, providing a wide range of research opportunities. Understanding the various aspects of psychiatric-mental health nursing is crucial for providing comprehensive care to patients with mental health issues. This section provides a comprehensive list of psychiatric-mental health nursing research paper topics, categorized into ten different areas of focus. These topics are carefully selected to cover the most pertinent issues and trends in the field, encouraging students to explore and contribute to the existing body of knowledge.

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Understanding Mental Health Disorders

• The role of genetic factors in the development of schizophrenia.
• The impact of childhood trauma on adult mental health.
• The relationship between anxiety disorders and cardiovascular diseases.
• The link between depression and chronic pain.
• The effect of sleep disorders on mental health.
• The role of nutrition in managing mental health disorders.
• The impact of substance abuse on mental health.
• The relationship between personality disorders and criminal behavior.
• The role of social support in managing bipolar disorder.
• The impact of post-traumatic stress disorder on quality of life.

Psychopharmacology in Mental Health Nursing

• The effectiveness of antidepressants in managing major depressive disorder.
• The side effects of antipsychotic medications.
• The role of mood stabilizers in managing bipolar disorder.
• The impact of benzodiazepines on cognitive function.
• The effectiveness of non-pharmacological interventions in managing anxiety disorders.
• The role of psychostimulants in managing attention deficit hyperactivity disorder (ADHD).
• The impact of medication adherence on treatment outcomes in schizophrenia.
• The role of pharmacogenomics in personalized treatment of mental health disorders.
• The effectiveness of electroconvulsive therapy in treatment-resistant depression.
• The impact of polypharmacy on treatment outcomes in elderly patients with mental health disorders.

Therapeutic Communication in Mental Health Nursing

• The impact of therapeutic communication on patient outcomes in mental health care.
• The role of non-verbal communication in building therapeutic relationships with patients.
• The effectiveness of motivational interviewing in substance abuse treatment.
• The impact of active listening on patient satisfaction and adherence to treatment.
• The role of empathy in mental health nursing.
• The effectiveness of group therapy in managing social anxiety disorder.
• The impact of family therapy on the mental health of adolescents.
• The role of cognitive-behavioral therapy in managing depression.
• The effectiveness of dialectical behavior therapy in managing borderline personality disorder.
• The impact of psychoeducation on the management of schizophrenia.

Mental Health Promotion and Prevention

• The role of school-based mental health programs in preventing adolescent depression.
• The effectiveness of community-based mental health promotion programs.
• The impact of workplace mental health promotion programs on employee well-being.
• The role of physical activity in preventing mental health disorders.
• The effectiveness of mindfulness-based stress reduction in preventing anxiety and depression.
• The impact of social support on the prevention of mental health disorders.
• The role of early intervention programs in preventing the development of psychosis.
• The effectiveness of suicide prevention programs in reducing suicide rates.
• The impact of anti-stigma campaigns on public attitudes towards mental health.
• The role of primary care providers in mental health promotion and prevention.

Legal and Ethical Issues in Mental Health Nursing

• The impact of involuntary hospitalization on the mental health of patients.
• The role of advanced directives in mental health care.
• The effectiveness of mental health courts in reducing recidivism rates.
• The impact of confidentiality breaches on the therapeutic relationship.
• The role of informed consent in mental health care.
• The effectiveness of restraint and seclusion in managing aggressive behavior.
• The impact of medication refusal on treatment outcomes.
• The role of ethics committees in resolving ethical dilemmas in mental health care.
• The effectiveness of de-escalation techniques in managing aggressive behavior.
• The impact of legal and ethical issues on the role of the mental health nurse.

Mental Health Nursing Across the Lifespan

• The impact of developmental stages on the mental health of individuals.
• The role of mental health nursing in the care of children and adolescents.
• The effectiveness of mental health interventions for older adults.
• The impact of life transitions on mental health.
• The role of mental health nursing in the care of pregnant and postpartum women.
• The effectiveness of mental health interventions for individuals with intellectual disabilities.
• The impact of aging on mental health.
• The role of mental health nursing in the care of individuals with dementia.
• The effectiveness of mental health interventions for adolescents with eating disorders.
• The impact of end-of-life care on the mental health of patients and their families.

Cultural Competence in Mental Health Nursing

• The impact of cultural competence on patient satisfaction and outcomes in mental health care.
• The role of cultural competence in building therapeutic relationships with patients from diverse backgrounds.
• The effectiveness of culturally tailored interventions in managing mental health disorders.
• The impact of language barriers on access to mental health care.
• The role of cultural competence in the assessment and diagnosis of mental health disorders.
• The effectiveness of cultural competence training for mental health professionals.
• The impact of cultural beliefs and practices on mental health.
• The role of cultural competence in the prevention of mental health disorders.
• The effectiveness of culturally adapted cognitive-behavioral therapy in managing depression.
• The impact of cultural competence on the delivery of mental health services to immigrant and refugee populations.

Psychiatric-Mental Health Nursing in Various Settings

• The role of mental health nursing in primary care settings.
• The effectiveness of mental health nursing interventions in acute care settings.
• The impact of mental health nursing on patient outcomes in long-term care settings.
• The role of mental health nursing in community mental health services.
• The effectiveness of mental health nursing interventions in correctional facilities.
• The impact of mental health nursing on patient outcomes in home health care.
• The role of mental health nursing in school-based mental health services.
• The effectiveness of mental health nursing interventions in emergency departments.
• The impact of mental health nursing on patient outcomes in psychiatric hospitals.
• The role of mental health nursing in substance abuse treatment centers.

Technological Advances in Mental Health Nursing

• The impact of telepsychiatry on access to mental health care in rural areas.
• The role of electronic health records in improving the quality of mental health care.
• The effectiveness of online support groups in managing mental health disorders.
• The impact of mobile applications on medication adherence in patients with mental health disorders.
• The role of virtual reality in the treatment of phobias.
• The effectiveness of online cognitive-behavioral therapy in managing anxiety disorders.
• The impact of teletherapy on patient satisfaction and outcomes in mental health care.
• The role of technology in enhancing communication between mental health professionals and patients.
• The effectiveness of online psychoeducation in the management of bipolar disorder.
• The impact of technology on the role of the mental health nurse.

Emerging Trends in Psychiatric-Mental Health Nursing

• The impact of the COVID-19 pandemic on the mental health of healthcare workers.
• The role of psychiatric-mental health nurses in addressing the opioid crisis.
• The effectiveness of trauma-informed care in managing post-traumatic stress disorder.
• The impact of the integration of mental health and primary care services on patient outcomes.
• The role of psychiatric-mental health nurses in addressing the mental health needs of LGBTQ+ populations.
• The effectiveness of peer support in the management of mental health disorders.
• The impact of climate change on mental health.
• The role of psychiatric-mental health nurses in addressing the mental health needs of immigrant and refugee populations.
• The effectiveness of mindfulness-based interventions in managing stress and burnout among mental health professionals.
• The impact of social media on mental health.

The psychiatric-mental health nursing field offers a vast array of research opportunities, as evident from the extensive list of topics provided above. These topics encompass various aspects of mental health care, from understanding mental health disorders to exploring the ethical and legal considerations in psychiatric-mental health nursing. It is crucial for students and professionals in the field to engage in research to contribute to the advancement of knowledge and improvement of mental health care. This list of psychiatric-mental health nursing research paper topics serves as a starting point for students to explore and contribute to this vital field of nursing.

The Range of Psychiatric-Mental Health Nursing Research Paper Topics

Psychiatric-mental health nursing is a specialized field of nursing that is dedicated to promoting mental health through the assessment, diagnosis, and treatment of mental health disorders and conditions. This field of nursing is incredibly important, as mental health disorders are prevalent and can have a significant impact on individuals’ overall health and well-being. According to the World Health Organization, approximately one in four people in the world will be affected by mental or neurological disorders at some point in their lives. This staggering statistic underscores the critical need for skilled psychiatric-mental health nurses who can provide comprehensive and compassionate care to individuals with mental health needs.

The significance of psychiatric-mental health nursing is multifaceted. First and foremost, psychiatric-mental health nurses play a crucial role in providing care and support to individuals with mental health disorders. They are often the first point of contact for individuals seeking help for mental health issues and play a key role in the assessment and diagnosis of mental health disorders. Psychiatric-mental health nurses also develop and implement treatment plans, provide psychoeducation to patients and their families, and offer support and counseling. Additionally, they play a vital role in crisis intervention and the management of acute mental health episodes.

Furthermore, psychiatric-mental health nurses also play a critical role in promoting mental health and preventing mental health disorders. They work in a variety of settings, including community mental health centers, schools, and primary care clinics, where they provide mental health education and promote strategies for maintaining good mental health. Additionally, psychiatric-mental health nurses often work in interdisciplinary teams, collaborating with other healthcare professionals, such as psychiatrists, psychologists, and social workers, to provide comprehensive care to individuals with mental health needs.

Various aspects of psychiatric-mental health nursing offer a wide range of psychiatric-mental health nursing research paper topics. One critical area of focus is mental health assessment. This involves the evaluation of an individual’s mental health status through the use of various assessment tools and techniques. Research in this area might explore the validity and reliability of different mental health assessment tools, the impact of cultural differences on mental health assessment, or the development of new assessment tools and techniques.

Another important aspect of psychiatric-mental health nursing is treatment and intervention strategies. This encompasses a wide range of approaches, from psychopharmacology to psychotherapy to lifestyle interventions. Psychiatric-mental health nursing research paper topics in this area might include the effectiveness of different treatment approaches for specific mental health disorders, the impact of treatment adherence on treatment outcomes, or the development of new intervention strategies.

The role of the psychiatric-mental health nurse is another crucial aspect of this field. Psychiatric-mental health nurses have a unique set of skills and competencies that enable them to provide comprehensive care to individuals with mental health needs. Research topics in this area might explore the impact of nurse-patient relationships on treatment outcomes, the role of psychiatric-mental health nurses in interdisciplinary teams, or the development of new competencies and skills for psychiatric-mental health nurses.

In addition to these areas, there are many other aspects of psychiatric-mental health nursing that offer a wealth of research opportunities. For example, legal and ethical issues in psychiatric-mental health nursing, the role of technology in mental health care, and the mental health needs of specific populations, such as the elderly, children, or individuals with co-occurring disorders, are all important areas of focus.

Overall, the field of psychiatric-mental health nursing offers a wide range of research opportunities. From mental health assessment to treatment and intervention strategies to the role of the psychiatric-mental health nurse, there are numerous psychiatric-mental health nursing research paper topics to explore. Engaging in research in this field is crucial for the advancement of knowledge and the improvement of mental health care for individuals around the world.

In conclusion, psychiatric-mental health nursing is a vital field that plays a crucial role in promoting mental health and providing care and support to individuals with mental health needs. The various aspects of psychiatric-mental health nursing offer a wide range of psychiatric-mental health nursing research paper topics, from mental health assessment to treatment and intervention strategies to the role of the psychiatric-mental health nurse. Engaging in research in this field is essential for advancing knowledge and improving mental health care worldwide.

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Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

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A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

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About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

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Mental Health Nursing Dissertation Topics

Published by Owen Ingram at January 3rd, 2023 , Revised On June 10, 2024

Are you passionate about helping others, especially those facing mental health challenges? If this is the case for you, then mental health nursing is a career choice you may want to pursue.

It can be challenging to work in the field of mental health nursing. The final year of the nursing undergraduate programme can be especially stressful because it involves completing a dissertation paper on a unique and interesting topic . Get a better understanding of mental health nursing, how it works, and how it can improve healthcare!

Similarly, Masters and PhD students of nursing and medicine must complete a research proposal and a thesis paper on a topic that really adds value to the research areas.

List of Trending Mental Health Nursing Dissertation Topics

• How does social media impact teenagers’ mental health?
• What techniques can nurses use to deal with their stress?
• How can nurses effectively serve veterans with mental health issues?
• How does interaction between families help the recovery of mental health patients?
• How can drugs affect mental health, and how can nurses assist with treatment?
• What kinds of mental health training should future nurses receive?
• What are the best methods for nurses to use to avoid suicide?
• How can nurses improve mental health in the workplace?
• How do nurses provide respectful mental health care?
• How does creative therapy fit into mental health nursing care?

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• Coronavirus (COVID-19) Nursing Dissertation Topics

Topic-1: Cognitive and emotional well-being

Research Aim: Finding out different ways to improve the cognitive and emotional well-being of people to solve the common mental health problems in the surrounding.

Topic-2: Eliminating mental illnesses

Research Aim: Encouraging better mental health by diagnosing the symptoms of mental health issues in the early stage to prevent severe circumstances later.

Topic-3: Providing specialised treatments

Research Aim: From anxiety, depression, and disorders to other mental health complexities, providing solutions to all types of mental health disorders, including pre-traumatic and post-traumatic issues.

Topic-4: Bipolar disorder

Research Aim: Explaining the symptoms, treatments, and procedures to soothe the common and impulsive mental health issues with solid behavior modification treatments.

Topic-5: Borderline personality disorder

Research Aim: Understanding the common borderline personality disorders and their effects on the mental health condition of different patients. Also, studying the unstable relationships with friends, family, and other associations and ways to improve it.

Topic-6: Dissociative disorders

Research Aim: Reviewing all the common causes of dissociative disorders and the primary care management to assess and intervene in different causes of the problem.

Topic-7: Disruptive and impulse-control disorders

Research Aim: Studying all the disruptive and impulsive-control disorders and their impact on the intermittent explosive condition and anti-social behavior of a person.

Topic-8: Attention deficit hyperactivity disorder

Research Aim: A brief overview of ADHD to control the attention span of a person through different effective techniques and procedures.

Topic-9: Psychosocial mental health nursing

Research Aim: Studying theories to understand human nature better and the process of normal development based on physical and mental health.

Topic-10: Mental health and psychiatric nursing

Research Aim: Exploring different types of mental illnesses and their treatments used to soothe the hyperactive condition of the patient.

Topic-11: Mental health educating

Research Aim: Educating everyone about the basic mental health problems and preventive measures to administer the condition of patients and to meet their varying mental health needs.

Topic-12: Providing different levels and quality of care to every patient

Research Aim: Studying the needs of every patient and providing care to solve different mental illnesses in a variety of ways helps tackle the problem calmly.

Topic-13: National and local mental health programs

Research Aim: Introducing different national and local mental health programs. Explaining their role in spreading awareness of the importance of mental health for individuals from different backgrounds.

Topic-14: Mental health checkups

Research Aim: Conveying the need for mental health checkups for individuals of all ages suffering from anxiety, stress, frustration, and other mental health issues.

Topic-15: Schizophrenia

Research Aim: Understanding the feelings of a patient suffering from schizophrenia and identifying its symptoms to curate the best and proper treatment for the stress cause.

Topic-16: Suicide prevention

Research Aim: Spreading awareness on suicide prevention, especially for youngsters and adults with the help of telephone and physical counselling. Finding the causes of suicide in professional spaces to get rid of the suicidal thoughts as early as possible.

Importance of Mental Health Nursing Profession

The number of people encountering poor mental health and related issues in their day-to-day lives is increasing, making mental health nursing a growing field in the healthcare industry. Those who are willing to work hard, be creative, and take risks in handling such patients can find many opportunities in this field.

Nurses in mental health are required to hold a bachelor’s degree, preferably a master’s degree. They also obtain additional training on dealing with people suffering from depression and different anxiety disorders.

According to the Bureau of Labor Statistics, mental health nurses’ demand will grow by 15% between 2014 and 2024. The need for nurses who specialise in this field will increase because of this growth rate.

Like other nursing jobs, mental health nursing pay depends on experience and education. The average salary for this career is $91,298 per year. According to a survey, salaries for mental health nurses can range from $71,485 to $129,837 per year, depending on their experience and education level.

There are still many challenges and rewards associated with a career in mental health nursing. Bringing peace to the lives of diverse people is a major part of the job. A flood of opportunities is always flowing your way as the field is constantly evolving. Take some time to research all of the nursing degree programs available before you make a decision.

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How to find mental health nursing dissertation topics.

For mental health nursing dissertation topics:

• Research recent issues in mental health care.
• Explore treatment approaches or therapies.
• Examine stigma and advocacy.
• Focus on specific populations or disorders.
• Consult professionals for insights.
• Select a topic that resonates with you and contributes to the field.

What Is Mental Health Nursing?

Nursing in mental health focuses on preventing, treating, and rehabilitating behavioural, emotional, and mental disorders. Nursing professionals work with patients to improve their emotional well-being by overcoming mental stress. Patients with mental illness or disorders are also guided throughout their recovery.

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Mental health in nursing

A student's perspective.

Halsted, Candis DNP-PMHNP, RN; Hart, Virginia T. DNP, RN, PMHNP-BC

At Radford University School of Nursing in Radford, Va., Candis Halsted recently earned her DNP and Virginia T. Hart is an assistant professor and interim psychiatric mental health NP program coordinator.

The authors have disclosed no financial relationships related to this article.

A stigma around mental health issues within healthcare and nursing itself has created a culture of perfectionism in the workplace, and nurses struggle to live up to the expectations while pushing aside their feelings, thoughts, and needs. Inspired by one author's personal experiences, this article explores mental health issues many nurses confront today.

Inspired by one author's personal experiences, this article explores mental health issues many nurses confront today.

I DECIDED TO RETURN to school in 2015 after practicing as a nurse in various settings for 7 years. I subscribe to the adage that knowledge is power. My drive for additional education and experience was based on my desire to achieve a higher status, assume more control over my practice, and to garner more respect from other healthcare professionals. As I immersed myself in my graduate studies, however, I found my desires, self-image, and professional viewpoint had changed.

I have always endeavored to be the best student, greatest employee, and most dependable teammate. Those efforts took on a feverish intensity during periods of transition—student to nurse, nurse to working mother, mother and nurse to professional student. Good was not good enough, and my drive to be the best and greatest was an integral part of my self-worth. Unfortunately, it led to anxiety, depression, hopelessness, and isolation that negatively impacted my education, practice, and personal life.

It was not until my clinical rotations as a psychiatric-mental health NP student that I came to realize the magnitude of the situation. There I was, taking courses on trauma-informed care and giving my patients tools for building self-efficacy, self-compassion, and coping skills while simultaneously ignoring my own needs.

Having left the workplace to focus on my online studies, I was isolated, lacking confidence, feeling overwhelmed, and overcompensating for some perceived shortcoming that I could not even define. I felt hopeless and defeated. I experienced bouts of anxiety and depression so intense I lost my sense of purpose. I considered dropping out of school many times, but I gave in to the expectations of others. I forced myself to continue pushing aside my own needs, persisting despite my growing depression and anxiety.

Looking back, I had so many chances to speak up and reach out for help. I could have spoken with nurse managers, coworkers, fellow students, and faculty a hundred different ways on so many occasions. Instead, I allowed the culture of silence and my own perfectionism to rule.

At my lowest point, I made the life-altering decision to reach out for help—first to my husband, then a therapist, a fellow student, and finally my school faculty. With their assistance, some serious self-reflection, and a lot of self-help reading, I am working to address my mental illness and establish a sense of well-being.

That is not to say that I have it all figured out. I still struggle many days to keep faith in my strengths and abilities. The things I have learned and witnessed, the obstacles I have encountered and overcome, whether academic, professional, or personal, have humbled me and restored my desire to return to the love, service, and justice at the core of my professional drive and practice. I am once again prioritizing my values and making sure my actions reflect them. Among those values is the desire to work toward the unification of our profession and to advocate for policy changes that support the mental health of all nurses. Inspired by my personal experiences, this article explores mental health issues many nurses confront today.

A pervasive problem

Although mental health and suicide among nurses have emerged as areas of professional concern in recent years, little research or literature exists regarding profession-specific risk factors, prevalence of mental illness, and suicide rates. With little to no concrete statistics to draw from, the true incidence of mental illness within the nursing profession is unknown. Furthermore, little has been done to bring these problems to the attention of the general public or to acquire the recognition and support of the professional community. 1-3

What can be found are decades of research stating that nursing is psychologically demanding and can contribute to poor mental health in a variety of ways, such as depression, anxiety, secondary trauma, compassion fatigue, and burnout. 1-7 The occupational hazards of nursing can also compromise work-life balance. Add to this various individual risk factors such as genetic predisposition or history of personal trauma, as well as the fact that academic standards for the profession favor those who are exacting and high-performing. It stands to reason that nurses are in jeopardy of significantly elevated levels of stress and maladaptive coping. 5,8 When ongoing, this can lead to impaired functioning. In the professional setting, impairment has been correlated with increased risk for errors, patient harm, and clinical ineffectiveness. 9

Mental illness can be defined as clinically significant impairment in social, conceptual, and practical functioning. 9,10 Although very common, mental illness is often untreated. 11 One in five adults will have some experience with mental illness each year, but less than half will receive treatment. 11

Nursing has a hidden culture of stigma and silence regarding mental illness, which serves to minimize and overshadow those experiencing clinically significant distress. 6,12 Competition, intimidation, and bullying among nurses are pervasive across practice and in academic settings. 13,14 These behaviors can breed psychologically hazardous and hostile environments. Fear of becoming a target may result in blame, shame, self-stigmatization, isolation, and suffering in any individual with potentially undesirable characteristics in such settings, regardless of his or her mental health status. Such abuses and fear can promote conformity and negatively impact disclosure and help-seeking behaviors in stressed, distressed, and impaired individuals. 1,2,5,13

The issue is exacerbated by a lack of respect and recognition for nursing that is still present within the healthcare culture at large. The traditional hierarchy holds physicians as experts, not nurses. Even advanced practice nurses are diminished, often referred to as “mid-level providers” and “physician extenders.” 15 These attitudes undermine the autonomy and dignity of nurses, especially when they collaborate with other healthcare disciplines. 14

In addition, while healthcare entities and societies champion the rights of the patient, the need to protect the basic human dignity and professional image of nurses is often overlooked. 14 Fundamental protections and rights for nurses are being compromised every day when we are expected to tolerate long hours, interrupted (or nonexistent) breaks, heavy patient caseloads, incivility, and even violence in the workplace. Nurse unions across the country are threatening walkouts and going on strike because of the failure of hospitals to address these issues. 16,17 The situation is not helped by the fact that guiding and governing bodies for nursing practice are numerous yet, in my opinion, self-segregated.

Systemic change

Although some organizations have created emotional wellness programs, a cohesive or public effort to address systemic problems is lacking. 1-3 Until employers, boards of nursing, and nursing organizations place the same importance on the well-being of nurses and risk mitigation, nurses may continue to suffer in silence. Within the currently disjointed system, we cannot hope to make substantive changes without offering our passion and expertise as well as identifying and supporting means for promoting self-care and wellness among the thousands of practicing nurses and preprofessionals experiencing distress or symptoms of mental illness.

Pressures and barriers to mental health and help-seeking extend to the academic setting. 4-5 For professional nurses returning to school, the pressure associated with practice and professional expectations may be exacerbated by their increased need to balance a variety of personal and/or family responsibilities, deadlines, financial obligations, leisure time, and peer competitiveness. Despite these contributory risk factors, I have seen few—if any—educational programs for health and helping disciplines, such as nursing, medicine, and social work, place value on assessing students' stress and distress. In commiserative discussions with others doing graduate work in nursing, social work, occupational therapy, and physical therapy, I have yet to meet anyone who felt the faculty took action to address the genuine difficulties many of them faced in balancing their lives. In short, students (myself included) feel devalued by the lack of respect, holistic consideration, and mentorship they encounter. Academic learning environments have a great need to support improvement of the emotional well-being and psychological resiliency of students and for improving the accessibility of support, counseling, and mental health resources. 4,5

I encourage you to take a long, hard look at yourself and those around you. If you are struggling, please reach out to someone you trust and let them know you are not okay. If you are not sure that what you are experiencing is normal or cause for concern, there are many websites that provide education and information on how to identify mental health problems, as well as hotline crisis intervention services and referrals to local counseling. These websites often have articles and tips on how to improve your mental health through physical, spiritual, and psychological self-care. (See Mental health resources .)

No mental health concern is too big or too small. If you are not well, talk to a friend, family member, professional, or help hotline. If you suspect a coworker, colleague, or student needs help, please reach out. Something as simple as asking if they are okay and giving them the space and time to express their feelings can make all the difference. As Edward Everett Hale once said, “I am only one, but still I am one. I cannot do everything, but still I can do something. And because I cannot do everything, I will not refuse to do the something that I can do.” 18 We owe it to ourselves, our profession, our patients, and their families to seek help and to offer help to our fellow nurses in need.

For anyone requiring immediate crisis intervention or assistance finding a local mental health provider, the following resources are available:

• Mental Health America: 1-866-400-6428 for referrals, 1-800-273-8255 for crisis
• National Alliance on Mental Illness HelpLine 1-800-950-6264
• National Suicide Prevention Helpline 1-800-273-8255

Crisis Text Line available 24 hours a day, text “HOME” to 741741

Mental health resources

• American Psychological Association
• www.apa.org
• American Psychiatric Nurses Association (APNA)
• www.apna.org
• MentalHealth.gov
• www.mentalhealth.gov
• National Alliance on Mental Illness
• www.nami.org
• National Suicide Prevention Lifeline
• https://suicidepreventionlifeline.org
• Crisis Text Line
• www.crisistextline.org
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anxiety; compassion fatigue; depression; emotional wellness; mental health; nursing; suicide prevention

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200+ Great Ideas of Nursing Research Topics to Get Started

Running out of topic ideas for your nursing research paper?

Stay on this page to find really cool and helpful lists of interesting research topics for your nursing dissertation or thesis.

What are Some Cool topics to Research?

Whenever students are asked to work on a research paper or present their thesis, the very first concern for them is choosing a unique, interesting, and research-worthy topic that makes their research significant and has enough future scope.

When it comes to finding a unique topic without working on something that’s already been done, most of the nursing and healthcare students struggle. A good research topic should be unique, relevant to current times, and have future scope as well. And you’ll find all three qualities in the topics mentioned below:

1. Primary Healthcare Nursing Research Topics

Primary healthcare refers to essential or basic health care service based on socially acceptable and scientifically sound methods and technology. Since it includes physical, social, emotional, and mental well-being, there are many topics for nursing scholars to explore:

• Strengthening primary healthcare system as the first line of referral system
• Introduction of home health nursing in the community set up
• Primary health care delivery system clinical pathways
• From home visits to home health care: strengthening primary health care delivery system
• Expanding the roles of community health nurses
• Millennial models of health care system
• Strengthening disease surveillance program in the community health setup
• Home health care of debilitated patients
• Acceptance of evidence-based practice in the primary health care
• Strengthening continuity of care in the community/home health care post-hospitalization
• Physical rehabilitation and occupational therapy in the community health care setting

2. Good Research Topics in Healthcare Management

Healthcare management is the management, administration, or oversight of healthcare systems, hospitals, public health systems, and other medical facilities. Since it comprises the overall management of all the work of the hospitals, it opens avenues for a lot of research work. Take, for example, the following:

• Evaluating who is responsible for failure in surgeries?
• Healthcare Contracts Limitations
• Medical Home Service
• Analysing nursing channels that nurses can use for becoming physicians?
• Gender Bias in Nursing Profession
• Starting Private Practice as a Nurse
• Medicare: Pros and Cons
• What are the most appropriate methods for increasing staff retention in a health care setting?
• Nursing Uniform Code Rules
• Role of nurses in enhancing a hospital quality improvement
• Legal Risks with Non-English Patients
• Medical Marijuana: Risk, Benefits, and Management Rules
• Shortage of Men in Healthcare
• Health tracking apps for continuity of care post discharge to home
• Telehealth: the impact of virtual care to urban and rural areas
• Strategic referral system to prevent tertiary hospital congestion
• Clinical pathways for referral system
• Drive-thru pharmacy
• Strenghtening the roles of social works and social workers in the health care team
• Case management approach in the healthcare delivery system
• Defining and application of Expected Length of Stay in patient management
• Impact of case managers in Expected Length of Stay and patient outcomes
• Redefining hospital cultures on bed rest versus mobilization
• Redefining hospital cultures on diet and food services
• Redefining hospital cultures on the assumption of the sick roles
• Strict implementation of Expected Length of Stay to prevent hospital congestion
• Roles of Case manager in the Clinical pathways
• Case Manager as a new nursing role an specialization
• Nurse navigator as a new form of nurse entrepreneurship
• Case management clinical pathway for smooth admission, patient flow and continuity of care after discharge
• Increase nursing specialization
• Internet savvy for healthcare providers

3. Nursing Research Topics about Pain Management

Pain management, in nursing, includes study of all the interventions nurses can make during their hospital hours – mainly to relieve a patient’s pain or ailments through medicinal interventions. Pain is complex, with many treatment options such as therapies, medicines, and also mind-body techniques. Nursing research scholars can research about the following topics:

• Pain management in children suffering from life-limiting illnesses: learning about the best practices
• Headache Treatment Protocol
• A closer look at hemophilia patient’s pain management
• Myofascial Pain Rehabilitation
• Labor and delivery: best practices for pain management
• Using Opioid for Rheumatoid Arthritis
• Fetal pain perception: analysis by medical experts
• Innovative Injection Use
• Therapeutic Injections: Cons & Pros
• Cognitive hypnotherapy application: how effective are they in pain management?
• Evaluating the effectiveness of Benson’s relaxation therapy as a pain management practice.
• Post-discharge pain-management strategies: evaluating their effectiveness in a health care setting?
• Phantom Pains Phenomenon
• Pain management in cancer patients: best practices according to expert nurses
• Spinal cord nerve injury related to chronic constipation
• Mobile pain unit

4. Pediatric Nursing Research Topics

In Pediatric nursing, the nursing staff is responsible for medical care of the children and neonates, and adolescents – mainly in a day-clinic or the in-patient setting. Though the main role of child health nursing is administering procedures and medicines to all children as per their prescribed nursing care plans, the research scholars can write papers on the following topics:

• Speech Disorders Therapy
• ADHD Causes & treatment
• Prevalence of misdiagnosis in child health or paediatric ward
• Vaccination & Autism
• Systematic review of range of child health nursing services in UK
• Antibiotic Resistance in Preschool Children
• Mental and Emotional health of children under 10
• Eating Disorders in Children
• Social Media Impact on Teenagers
• Seizures Causes in Infants
• Teething issues in children under 10
• Psychological Aspects of Infant Care
• Use of social media platforms in preparation and prevention of hospital phobia among pediatric groups
• Family engagement in the pediatric care by using hospital information system
• Safety and efficacy of telehealth for pediatric patients

What are the Current issues in Nursing?

Nursing is a high-pressure job. It demands patience, determination, and perseverance. As a high-pressure job, it gets quite challenging and leads to issues from time to time. Some of the examples being staff shortages, long working hours, workplace hazards, personal health, and workplace violence. All of these can be addressed in nursing research papers:

• Analysis of the registered nurse workforce and the relationship to work environments
• Transforming loss: A developing concept for nursing
• Nursing Staff Shortages
• Nursing Practitioners
• Meeting Patient Expectations: A challenge for nurses
• Biggest obstacles nurses face in their education and maintaining career alongside
• Workplace Violence and Hazards Nurses face
• Diversity in Healthcare
• Importance of Community Nursing
• Future of Nursing in the Digital Age
• What measure can a nurse take for helping a person with their eating disorder?
• Clinical Nurse Roles
• How can nurses help in treating patients who already know they don’t have a survival rate?
• Ethics and Homeless People Treatment
• Critical Care Nursing Management
• A nurse’s role in helping and assisting patients with chronic diseases?
• Nursing Theorists Works
• Remote Intensive Care Unit
• Stress Management Practice for Nurses Working in Night Shifts
• Between Career & Professional Service
• Preceptorship and training after distant education program and online learning
• Centralized infectious disease surveillance
• Centralized reporting of chronic diseases
• Patient become more educated: the pros and cons of social media
• Fake news and misinformation on health related issue with the rise of social media platforms
• BPO and call centers for medical procedures booking and admission to decongest emergency room
• Application of BPO in the quality assurance monitoring in documentation

What are Some of the Research Topic Ideas in Surgical Nursing?

• Moral distress among nurses in Surgical units
• Patient’s satisfaction and experience about care provided by nurses in the surgical units
• Organizational effects on patient satisfaction in surgical units
• Medical-Surgical nurses and their perceived leadership abilities as responders in patient deterioration events
• Role of Nurses in Surgical Wards
• Medical-surgical nursing: Critical thinking in client care
• Pain assessment and management in surgical nursing
• Understanding technology in contemporary surgical nursing
• Understanding Medical surgical nursing as an integrated approach
• Standardising fast-track surgical nursing care
• Mobilization team for the fast recovery of post-operative patients
• Use of telehealth for pre-operative preparations and elective surgical admissions to lessen hospital length of stay among surgical patients
• Continuity of care post surgery in the community health care

What have been some of the more important nursing research questions discussed in nursing class?

If you are here to find more important topics for your nursing dissertations, then scroll through this section for topics that are often discussed in nursing classes. Nursing research articles and topics change over time. However, we find these relevant to current times and challenges in healthcare:

1. Research topic ideas for Midwifery Nursing

Nurse-midwife, as a licensed healthcare professional, specialises in child birth and also women’s reproductive health. Apart from attending pregnant women during childbirth, they are responsible for several roles during emergencies, and pre and postnatal care. Hence, opening avenues for research topics such as:

• Role of nurses in improving patient safety during childbirth: Evidence from obstetric trauma
• Evaluate the impact of delayed umbilical cord clamping after child birth
• Maternal & Neonatal Practices in Rural Areas
• Emerging trends in obstetrical and midwifery nursing
• First Antenatal Appointment Analysis
• Limiting interventions during a low-risk labour
• Mental Illness & Post-natal Period
• Analysing the role of prenatal care in pregnant women
• Shift Study Midwives & Length
• Evaluating impact of AIDS and Hepatitis B in the pregnant women
• Self-Instruction Kits & Natal Safety
• Studying advanced trends in obstetrics and gynaecology
• Midwifery Continued Care
• Evaluating pros and cons of labouring in water
• Gestational Weight Gain Challenges
• Vitamin D’s role as a supplement during pregnancy
• Studying clinical reasoning integration into midwifery practice
• Obese Pregnant Women Safety Rules
• A decade after BEmONC and CEmONC

2. Health Promotion Research Topics

Health promotion mainly comes from behavioral social science which draws from the environmental, biological, psychological, medical, and physical sciences for promoting health and preventing diseases. For health promotion, the research topics include the following:

• Healthcare Dangers of Digital Age
• Benefits and Shortages of Telemedicine
• Healthy living and Preventive medicine for Senior Citizens
• Role of School Nurses
• Obstacles for Smoking cessation
• Healthy Eating & Sports
• Causes of Youth Inactivity
• Roles of Parents for Healthy Lifestyle of Children
• Obesity and Mental Stability
• Pharmacist Responsibility
• Social Media and Educational Strategies
• HealthBank as new form of medical insurance inside the hospital organization
• Collaboration of private health insurance company with public and private hospitals

3. Adult Research Topics for Nursing Students

As a nursing scholar, you can also write research papers on adult healthcare, disease prevention, and management. Take, for example, reasons behind anxiety disorders in adults. Find more topics in the list below:

• Nurses’ experiences with urinary catheter insertion: A qualitative focus group study
• Clinical Cardiology Innovations
• CV Imaging Process
• Migraine Case Example
• Bipolar Disorder Non-Chemical Practices
• Mental Health & Psychiatric Care in Adults
• Online nursing education program
• Self care in Nursing
• Home health care for longterm vented patients
• Clinical Instructor, Preceptorship, Educator and Professor as specialized field requiring licensure
• Specialization program in nursing education

4. Geriatric Care Nursing Journal Topics

Nurses working in Geriatric care and management are responsible for coordinating and planning care of the elderly people dealing with mental or physical disabilities. Some of the research work topic ideas for geriatric care include the following:

• Cerebrovascular Disease and Stroke in Elderly people
• Pain in elderly people: Assessment and Management
• Joint Disorders Study in Elderly Population
• Rapid Nutritional assessment in Elderly
• Alzheimer’s Disease
• Bladder Cancer Therapy
• Atrial Fibrillation Study
• Critical Care Requirements
• Cardiovascular Risk Reduction
• Geriatrics Ethics
• Restless Legs Syndrome
• Parkinson’s Disease Precautions
• Geriatric care clinical pathways of care: holistic approach

What are the recent nursing research paper topics?

If you’re facing the challenge of choosing a recent nursing research topic, we’ve got your back. Many nurses, including experienced and freshers, are faced with this challenge at some point. But there’s no need to panic. So, without further ado, let’s jump-start the list of most recent research topics for nursing students:

1. Women’s Health Nursing Research Topics

Research topics related to women’s health are always trending, relevant, and have future scope as well. Hence, these topics are still worth exploring and researching:

• Culture affects women’s health
• Substance Abuse and Addiction in Women
• Menopause Challenges
• Infertility Ethical Rules
• Ovarian Cancer and Ovarian Disorder Analysis
• Modern Neonatal Practices
• Pregnancy Prevention Measures
• Sepsis after labour
• Cosmetic Dermatology
• Cystic Fibroids
• Sleep Disorders in Women
• Reproductive Endocrinology
• Women’s Sexual Health Disorders
• HPV and Cervical Cancer
• Vaginal Atrophy Causes
• Sleep disturbances in Women

2. Mental Health Nursing Research Articles Topics

Research papers focusing on mental health are still one of the most read and referred papers. And there’s still more scope for research on topics such as:

• Evaluating the concept of Integrated Mental and Physical Health Care
• Psychiatric Nursing and Mental Health
• Possible skills required for Nurses in Mental health care setting
• Assessing the mental health of nurses
• Depression Causes
• Schizophrenia Diagnostics
• Alcohol Addiction Disorders
• Bipolar Disorder
• Studying the impact of PTSD in the Army Veterans
• Impact of Video Games on Teenage Aggression
• Stress Among Police Officers
• Psychiatric Patient Ethics
• Forbidden Substances: Prevention and Use
• Bioterrorism Medicine
• Physical Traumas & Recovery Methods
• Application of Nursing Case Management in Psychiatry

Nursing leaders have called for research focusing on which of the following topics?

If you’d like to take an expert’s opinion before choosing a topic for your nursing dissertation, this section will be helpful. Our list of best nursing research topics doesn’t end here. We’ve got here more interesting topics that are recommended by nursing leaders and experts. Take a look at some more relevant topics:

• Preterm Labor Dangers
• Labor and Delivery Management Practices
• Saving Mother & Child Challenges
• Abortion Care Ethical Side
• Adolescent Gynecology Education
• Antenatal Care Recommendations
• Hypertensive Disorders Causes
• Newborn Resuscitation Rules
• Caesarean Section Preparation
• Delivery Room Behavior Checklist
• Nurses play vital roles in healthcare. Why are they invisible in the media?
• Increasing nursing research capacity: The roles of nurse scientists within healthcare systems
• Microeconomics and macroeconomics for sources of hospital funds
• Diverting patients and funds to economical services
• Culture vs evidence based practice
• Social media influencer in health education dissemination
• Acceptance of evidence based practice in the hospital
• Impact of socio-cultural nursing to evidence-based practice
• Hindrances in the implementation of evidence-based practice
• Nursing faculty shortage and brain-drain
• Online continuing professional education and development

Final Thoughts

Nursing research topics for a dissertation or thesis should not be difficult to find through the ideas suggestion above. Just make sure that you provide a twist (segment or expand the topic, perhaps) and come up with a unique topic for your paper.

During the initial stages of finalising a nursing research topic, you can struggle with a lot of choices or overwhelming information. However, when you start to consider a research topic’s limitations and scope, and outline your topic into a question, you’ll be able to get a better understanding of the topic you can manage in terms of workload.

We hope these nursing research topics mentioned above help you find that unique thesis statement or idea you’re looking for. In case you’re still having a tough time making a choice, leave us a comment or drop a mail, and we will direct you to better resources.

• https://www.journals.elsevier.com/applied-nursing-research/recent-articles
• https://www.syberscribe.com.au/blog/10-emerging-trends-healthcare-technology-2019-beyond/
• https://www.purdueglobal.edu/blog/nursing/top-10-nursing-trends/
• http://ojin.nursingworld.org/

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Research Topics & Ideas: Nursing

50+ Nursing Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a nursing-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of nursing-related research ideas and topic thought-starters, including general nursing, medical-surgical nursing, pediatric nursing, obstetrics and gynaecological nursing, ICU and mental health nursing.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the nursing domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic. 

Overview: Nursing Research Topics

• General nursing-related topics
• Medical-surgical nursing
• Pediatric nursing
• Obstetrics and gynaecological nursing
• ICU nursing
• Mental health nursing

General Nursing Research Topics & Ideas

• The impact of cultural competence on patient care in the UK
• The importance of evidence-based practice in nursing for patients with HIV/AIDS
• The effects of workplace stress on nurse well-being and performance
• The role of nurse-patient communication for patients transitioning from adolescent to adult care
• The impact of technology on nursing practice and patient outcomes
• The importance of interdisciplinary collaboration in healthcare for the rehabilitation of patients post-surgery
• The effects of fatigue on nurse performance in the emergency room
• The impact of nurse staffing levels on patient outcomes in rural areas
• The effectiveness of nurse-led interventions in managing chronic conditions: a case study of diabetes
• The impact of patient-centred care on health outcomes for the elderly
• The importance of patient safety in nursing: bedside nurse vigilance
• The effects of empathy and compassion in critical care nursing
• The role of nursing in disaster preparedness and response: a case study of the Haiti earthquake of 2021
• The impact of the level of nursing education on patient outcomes
• The importance of ethical considerations in frail care nursing practice

Topics & Ideas: Medical-Surgical Nursing

• The impact of bedside care on patient outcomes in medical-surgical units
• The role of the nurse in managing post-operative patient pain
• The effects of nurse-patient ratios on patient outcomes in medical-surgical units
• A systematic review of different approaches to patient education in medical-surgical units
• The relationship between nurse-patient communication and patient satisfaction in medical-surgical units: perspectives and recommendations to improving patient satisfaction

Topics & Ideas: Pediatrics Nursing

• The impact of family-centered care on pediatric patient outcomes with sickle cell anemia
• The role of nursing interventions in promoting developmental and behavioral health in pediatric patients
• The effects of play therapy on anxiety and pain in pediatric patients during hospitilisation
• A systematic review of different approaches to pain management in pediatric cancer patients
• The relationship between parent involvement and post-operative patient outcomes in pediatric units

Ideas: Obstetrics and Gynecological Nursing

• The impact of nurse-led prenatal care on maternal and fetal outcomes in African American communities
• The role of the nurse in promoting sexual and reproductive health for women in the UK
• The effects of midwifery care on maternal satisfaction of primiparous women and birth outcomes
• A comparative study of different approaches to childbirth education for expectant mothers and partners: perceptions of control
• The relationship between lactation support and breastfeeding success of primiparous women

Topics & Ideas: ICU Nursing

• The impact of nursing interventions on patient outcomes in intensive care units in a developing country
• The role of the nurse in managing palliative and end-of-life care in the ICU
• The effects of family presence on patient outcomes and satisfaction in the ICU: A systematic review of the literature
• A comparative study of different approaches to pain management for trauma patients in the ICU
• The relationship between nurse-patient communication and geriatric patient outcomes in ICU

Topics & Ideas: Mental Health Nursing

• The impact of nurse-led therapy on adolescent patient outcomes in mental health settings
• The role of the nurse in promoting recovery and resiliency in mental health patients through group interventions
• The effects of mindfulness-based interventions on stress and anxiety in mental health patients: A systematic literature review
• A comparative study of the role of nurses in applying different approaches to patient education in mental health settings
• The association between nurse-patient therapeutic alliance and patient outcomes in mental health settings

Nursing Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a nursing-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various nursing-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Nursing Workload and Interventions of Licensed Nurses in Nursing Homes: An Observational Time and Motion Study (Kang, 2021)
• Missed Nursing Care: Accounting for Education, Experience, and Job Satisfaction in Registered Nurses (Bechard, 2021)
• Examining Predictors of Attitudes and Knowledge of Registered Nurses and Nursing Students in Tennessee toward Pregnant and Perinatal Women with a Substance Use Disorder (Patrylo, 2021)
• A Program Evaluation of the Organizational Readiness for Pathway to Excellence at Two Community Hospitals  (Behling, 2021)
• The Impact of Covid-19 Pandemic Policy Decisions on the Wellbeing of Nursing Home Residents in Missouri (White, 2022)
• Battling A Parallel Pandemic: An Evaluation of Sustainable System-Level Nursing Support in Response To COVID-19 (Gifford, 2022)
• Holistic Nursing Process Maps: a Tool for Student Nurses to Operationalize the Nursing Process to Increase Clinical Reasoning (Reyes, 2022)
• Satisfaction and Work-Life Balance in Undergraduate Nursing Faculty: A Mixed-Methods Study (Crawford, 2021)
• The Effect of Mindfulness Meditation on the Stress, Anxiety, Mindfulness, and Self-Compassion Levels of Nursing Students (Heinrich, 2022)
• Effectiveness of Simulation-Based Case Studies in Undergraduate Nursing Students (Becnel, 2022)
• A Telehealth Simulation Experiment: Exploring Prebriefing (Owen, 2022)
• Perceptions of Lateral Violence Among Vocational Nursing Students, Associate Degree Nursing Students, and Bachelor’s Degree Nursing Students (Martha, 2022)
• Nurse Educators’ Description of Ethics from a Disciplinary Perspective: A Qualitative Descriptive Research Study (Cuchetti, 2022)
• A Literature Review of the Relationship Between Oral Health and Pneumonia Risk in the Geriatric Nursing Home Population (Swift, 2021)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

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If you’re still feeling a bit unsure about how to find a research topic for your nursing dissertation, thesis or research project, check out our private coaching services below.

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Top Nursing Research Topics for Students and Professionals

This article was written in collaboration with Christine T. and ChatGPT, our little helper developed by OpenAI.

Nursing research is an essential component of the nursing profession. Its primary purpose is to enhance patient outcomes, elevate the quality of care, and advance nursing as a whole. For nursing students and practitioners, selecting an appropriate research topic is crucial for academic and professional success. This article highlights some current and interesting topics in nursing research that students and professionals can explore.

Nursing Workforce

One of the major topics in nursing research is the challenges that nurses face in their workplace, and how to address them. This is particularly relevant in light of the current shortage of nurses and the healthcare industry’s growing demands.

List of Nursing Research Topics: Nursing Workforce

• The impact of nurse staffing levels on patient outcomes in acute care settings
• The effectiveness of nurse retention strategies on improving nurse job satisfaction
• The role of nursing leadership in creating a positive work environment
• The relationship between nurse staffing ratios and nurse burnout
• The impact of nurse-to-patient ratios on nursing care quality in long-term care settings
• The effectiveness of nurse residency programs in improving new nurse retention rates
• The impact of nursing unit culture on nurse job satisfaction and retention
• The impact of nurse-patient ratios on patient outcomes
• Strategies for retaining experienced nurses in the workforce
• Analyzing the role of advanced practice nurses in healthcare teams
• The challenges and benefits of international nursing recruitment
• Addressing generational differences in the nursing workforce
• The relationship between nurse work schedules and nurse burnout
• The impact of nurse staffing levels on medication errors in hospital settings
• The role of interprofessional collaboration in reducing nursing workload and improving patient outcomes
• The impact of nursing education level on nursing practice and patient outcomes
• The relationship between nurse staffing levels and patient falls in acute care settings
• The impact of nurse workload on patient satisfaction with nursing care
• The role of nursing leadership in promoting staff well-being and reducing burnout
• The relationship between nurse staffing levels and patient mortality rates in critical care settings
• The effectiveness of nurse-led care models in improving patient outcomes and reducing healthcare costs
• The impact of nurse staffing levels on patient readmission rates in acute care settings
• The role of nursing autonomy in improving nursing practice and patient outcomes
• The relationship between nurse job satisfaction and patient outcomes in long-term care settings
• The impact of nursing staff turnover on patient safety and quality of care
• Healthcare management: career paths and requirements
• The role of technology in improving nursing efficiency and reducing workload
• The relationship between nurse staffing levels and patient satisfaction with nursing care
• The impact of nurse staffing levels on nurse job stress and burnout in pediatric settings
• The effectiveness of nurse-led interventions in improving patient outcomes for chronic conditions
• The role of nursing leadership in promoting a culture of safety and reducing patient harm
• The relationship between nurse staffing levels and patient outcomes in psychiatric settings
• The impact of nurse staffing levels on nurse job satisfaction and burnout in emergency departments
• The effectiveness of nursing education programs in improving nurse practice and patient outcomes
• The role of nurse practitioners in improving access to healthcare in underserved communities
• The relationship between nurse staffing levels and patient outcomes in rehabilitation settings
• The impact of nurse staffing levels on nurse retention rates in rural healthcare facilities
• The effectiveness of nurse-led discharge planning in reducing hospital readmissions
• The role of nursing leadership in promoting interprofessional collaboration and teamwork
• The relationship between nurse staffing levels and patient outcomes in outpatient care settings
• The impact of nursing workloads on patient safety in intensive care units
• The role of nursing research in improving nursing practice and patient outcomes
• The relationship between nurse staffing levels and nurse job satisfaction in surgical settings
• The impact of nurse staffing levels on patient satisfaction with pain management in acute care settings
• The effectiveness of nursing education programs in improving nursing knowledge and skills
• The role of nursing advocacy in promoting patient-centered care and improving healthcare outcomes

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Patient Safety

Another crucial area of nursing research is patient safety. Studying ways to enhance patient safety, reduce adverse events, and improve the quality of care in hospitals and other healthcare settings can help prevent patient harm and improve patient outcomes.

List of Nursing Research Topics: Patient Safety

• Exploring the impact of workplace stress on nurses’ job satisfaction and performance
• Investigating the factors that influence nurse turnover and retention rates
• Assessing the role of nurse staffing levels in patient outcomes and quality of care
• Examining the relationship between nurse burnout and patient safety incidents
• Investigating the effectiveness of nursing leadership in creating a positive work environment
• The influence of nursing handovers on patient safety
• Strategies to reduce medication errors in hospital settings
• The role of electronic health records in enhancing patient safety
• Impact of nurse-to-patient ratios on patient safety outcomes
• Evaluating the effectiveness of patient safety training programs for nurses
• Exploring the experiences of nurses from diverse backgrounds in the workplace
• Assessing the impact of shift work on nurses’ physical and mental health
• Investigating the relationship between nurse-patient ratios and patient outcomes
• Examining the role of interprofessional collaboration in improving the nursing work environment
• Exploring the use of technology to improve nursing workflow and productivity
• Mitigating the economic and social costs of heart diseases among the aging population in the US
• Investigating the effectiveness of nursing mentorship programs in retaining new nurses
• Assessing the role of organizational culture in promoting nurse well-being and job satisfaction
• Examining the impact of nursing education on nursing workforce preparedness
• Exploring the factors that contribute to job satisfaction among nurses
• Combating health care-associated infections: a community-based approach
• Investigating the impact of nurse-led care on patient outcomes and satisfaction
• Assessing the effectiveness of nursing support programs for nurses with mental health issues
• Examining the role of nursing unions in advocating for the nursing workforce
• Exploring the experiences of male nurses in the nursing workforce
• Investigating the effectiveness of nurse-led clinics in reducing emergency department visits
• Assessing the impact of nursing teamwork on patient outcomes and quality of care
• Examining the role of nursing informatics in improving nursing workflow and patient care
• Exploring the impact of nursing shortages on patient outcomes and quality of care
• Investigating the effectiveness of nurse-led interventions for reducing hospital readmissions
• Assessing the impact of nursing certification on nursing workforce competence and confidence
• Examining the role of nursing education in promoting cultural competence in the nursing workforce
• Exploring the experiences of nurses working in rural healthcare settings
• Investigating the effectiveness of nursing delegation in improving patient outcomes and quality of care
• Assessing the impact of nursing shortages on nurse job satisfaction and burnout
• Examining the role of nursing research in informing nursing workforce policies and practices
• Exploring the impact of nurse-led quality improvement initiatives on patient outcomes and satisfaction
• Investigating the role of nursing leaders in promoting nursing workforce diversity and inclusion
• Assessing the impact of nursing autonomy on nurse job satisfaction and performance
• Examining the effectiveness of nursing residency programs in preparing new nurses for the workforce
• Exploring the experiences of nurses working in correctional healthcare settings
• Investigating the impact of nurse staffing levels on patient falls and injuries
• Assessing the role of nursing education in promoting evidence-based practice in the nursing workforce
• Examining the effectiveness of nursing preceptorship programs in improving nurse job satisfaction and retention
• Exploring the role of nursing education in preparing nurses for leadership roles in the nursing workforce
• Investigating the effectiveness of nursing empowerment interventions in improving nursing job satisfaction and performance
• Assessing the impact of nursing shortages on the quality of nursing care provided to older adults in long-term care facilities.

Chronic Illness Management

Managing chronic diseases, such as diabetes, cancer, and heart disease, is a significant challenge for healthcare providers. Exploring different strategies for chronic disease management can help improve patient outcomes and enhance the quality of care.

List of Nursing Research Topics: Chronic Illness Management

• The Role of Nurses in Managing Chronic Heart Disease
• Impact of Nurse-led Interventions in Managing Chronic Obstructive Pulmonary Disease (COPD)
• The Effectiveness of Self-management Education in Patients with Type 2 Diabetes
• Nursing Strategies for Chronic Pain Management
• Chronic Kidney Disease Management: A Nursing Perspective
• Palliative Care in Chronic Illness Management
• Community Nursing and Chronic Illness: A Study on Patient Outcomes
• The Role of Nurses in Managing Chronic Pediatric Asthma
• Telehealth and Chronic Disease Management: The Future of Nursing Practice?
• Evaluating the role of nursing in diabetes self-management
• Strategies for improving patient adherence to chronic illness treatment plans
• The impact of nurse-led interventions on chronic obstructive pulmonary disease (COPD) management
• Exploring the role of telehealth in chronic illness follow-up and monitoring
• The effectiveness of nurse-led educational programs for patients with cardiovascular diseases
• The Importance of Nurse-led Clinics in Chronic Illness Management
• The Role of Nursing in Depression Management among Chronically Ill Patients
• Empowering the vulnerable: enhancing health and social care for individuals with specific needs
• Advanced Practice Nurses and Chronic Illness Management: A Systematic Review
• The Impact of Holistic Nursing Care on Chronic Disease Management
• The Effect of Nurse-led Health Education on Compliance in Chronic Disease Patients
• The Role of Family Nurses in the Management of Chronic Illness in Home Settings
• Nursing and the Management of Chronic Illness in Geriatric Populations
• The Influence of Nursing Interventions on Quality of Life in Patients with Chronic Illness
• Challenges Faced by Nurses in Managing Chronic Illness in Low-resource Settings
• Cancer Pain: Assessment, Management, and Patient Empowerment
• Evaluating the Role of School Nurses in Managing Chronic Illnesses in Children
• Developing a Chronic Disease Management Model: The Crucial Role of Nursing
• Nursing Intervention in Lifestyle Modification for Chronic Illness Patients
• The Impact of Patient-Nurse Communication in Chronic Illness Management
• The Role of Nursing in Medication Management for Chronic Illness Patients
• The Effects of Nursing Care Coordination on Chronic Illness Outcomes
• Mental Health and Chronic Illness: The Importance of Psychiatric Nursing
• The Role of Nursing in the Self-Management of Chronic Illness: A Meta-Analysis
• Nursing Interventions for Chronic Illness Management in Rural Areas
• Nurses’ Role in Reducing Hospital Readmissions for Chronic Illness Patients
• Digital healthcare and organizational learning: enhancing patient care through technology and knowledge management
• The Impact of Nursing on Patient Empowerment in Chronic Illness Management
• Cultural Competence in Nursing and Its Effect on Chronic Disease Management
• The Role of Nursing Informatics in Chronic Illness Management
• Evaluating the Role of Community Health Nurses in Chronic Illness Prevention
• The Impact of Home Nursing on Chronic Illness Management in Aging Populations
• The ongoing risk of HIV/AIDS among men who have sex with men
• The Role of Oncology Nurses in the Management of Chronic Cancer Pain
• The Effects of Nursing-led Cognitive Behavioral Therapy in Chronic Illness Management
• The Impact of Advanced Nursing Practice on Health Outcomes in Chronic Disease Management
• The Use of Digital Health Technologies in Chronic Disease Management: A Nursing Perspective

Mental Health

Promoting mental health and well-being in vulnerable patient populations is another important area of nursing research. Nurses can investigate various interventions and programs that can help prevent mental health problems and improve patients’ overall well-being.

List of Nursing Research Topics: Mental Health

• The impact of COVID-19 on mental health in healthcare workers
• The effectiveness of telehealth for delivering mental health services
• The role of social support in promoting mental health and wellbeing
• Investigating the effectiveness of mindfulness-based interventions for mental health
• Examining the use of virtual reality in treating mental health disorders
• The impact of sleep on mental health outcomes
• The role of exercise in promoting mental health and wellbeing
• The effectiveness of psychotherapy in treating depression
• Exploring the relationship between mental health and chronic pain
• Investigating the impact of workplace stress on mental health in nurses
• The effectiveness of nurse-led interventions for patients with depression
• Exploring the impact of nurse-patient relationships on mental health outcomes
• Strategies for improving mental health literacy among nursing professionals
• Evaluating the role of nurses in suicide prevention and intervention
• The challenges and strategies in nursing care for patients with dual diagnoses (co-existing mental health and substance use disorders)
• Examining the use of music therapy for mental health promotion
• The effectiveness of cognitive-behavioral therapy for anxiety disorders
• The relationship between mental health and nutrition
• The impact of trauma on mental health outcomes
• Investigating the use of art therapy in promoting mental health and wellbeing
• The role of spirituality in mental health and coping
• The effectiveness of group therapy for mental health disorders
• The impact of stigma on mental health outcomes
• Examining the effectiveness of psychopharmacology in treating mental health disorders
• The role of family support in promoting mental health and wellbeing
• Investigating the relationship between mental health and substance abuse
• The effectiveness of animal-assisted therapy in promoting mental health and wellbeing
• The impact of social media on mental health outcomes
• Examining the use of humor in promoting mental health and wellbeing
• The effectiveness of cognitive training for improving mental health outcomes
• Investigating the impact of gender and cultural factors on mental health outcomes
• The role of occupational therapy in promoting mental health and wellbeing
• Examining the effectiveness of acceptance and commitment therapy for mental health disorders
• The relationship between mental health and physical activity
• Investigating the use of peer support for mental health promotion
• The effectiveness of mindfulness-based stress reduction for mental health
• The impact of technology on mental health outcomes
• The role of nutrition in treating mental health disorders
• Examining the use of hypnotherapy in promoting mental health and wellbeing
• The effectiveness of psychotherapy for PTSD
• Investigating the relationship between mental health and social determinants of health
• The impact of social isolation on mental health outcomes
• Examining the use of dance therapy in promoting mental health and wellbeing
• The effectiveness of cognitive processing therapy for mental health disorders
• The role of self-care in promoting mental health and wellbeing in nurses

Health Promotion

Research into health promotion strategies using technology, social media, and other digital tools is a rapidly growing area of nursing research. Such research can help identify innovative and effective ways to promote health and well-being in communities and patient populations.

List of Nursing Research Topics: Health Promotion

• The effectiveness of community-based interventions in promoting physical activity and healthy eating habits
• Investigating the impact of social media on health behavior and lifestyle changes
• The role of nursing in promoting healthy behaviors and preventing chronic diseases
• Identifying effective strategies for improving health literacy among underserved populations
• Exploring the use of wearable technology in promoting physical activity and healthy lifestyles
• Evaluating the effectiveness of nurse-led health promotion campaigns on community health outcomes
• The role of nurses in promoting vaccinations in various populations
• Strategies for nurses to address health literacy and its impact on patient outcomes
• The influence of cultural competence in health promotion and disease prevention
• Assessing the role of nurses in promoting physical activity and healthy lifestyles in at-risk populations
• Investigating the role of family support in promoting healthy behaviors among children and adolescents
• Examining the effectiveness of peer-led interventions in promoting healthy lifestyles
• Investigating the impact of workplace wellness programs on employee health and productivity
• The impact of milk consumption on children’s growth
• The role of nursing in promoting smoking cessation and reducing tobacco use
• Exploring the use of motivational interviewing in promoting behavior change and improving health outcomes
• Investigating the effectiveness of mindfulness-based interventions in promoting mental and physical health
• The role of social support in promoting healthy behaviors and preventing chronic diseases
• Examining the effectiveness of school-based interventions in promoting healthy behaviors among children and adolescents
• Exploring the use of technology in promoting health education and behavior change
• Investigating the role of culture and ethnicity in promoting healthy behaviors and preventing chronic diseases
• Nursing: a beautiful blend of art and science
• Examining the effectiveness of community health worker programs in promoting healthy lifestyles
• The role of nursing in promoting healthy aging and preventing age-related diseases
• Investigating the impact of environmental factors on health behavior and lifestyle changes
• Exploring the use of incentives in promoting behavior change and improving health outcomes
• Investigating the effectiveness of group-based interventions in promoting healthy lifestyles
• Examining the impact of policy interventions on health behavior and lifestyle changes
• The effects of sleep deprivation on students’ cognitive functions and emotional state
• The role of nursing in promoting healthy sleep habits and reducing sleep disorders
• Investigating the effectiveness of mobile health interventions in promoting behavior change and improving health outcomes
• Exploring the use of positive psychology interventions in promoting mental and physical health
• Investigating the role of healthcare providers in promoting healthy behaviors and preventing chronic diseases
• Examining the effectiveness of workplace policies in promoting healthy lifestyles
• The role of nursing in promoting healthy sexual behaviors and preventing sexually transmitted infections
• Investigating the impact of stress on health behavior and lifestyle changes
• Exploring the use of community-based participatory research in promoting healthy behaviors and preventing chronic diseases
• The delicate dance: balancing art and science in the nursing profession
• Investigating the role of nutrition in promoting healthy behaviors and preventing chronic diseases
• Examining the effectiveness of self-management interventions in promoting healthy lifestyles
• The role of nursing in promoting healthy pregnancy and preventing maternal and child health problems
• Investigating the impact of socioeconomic status on health behavior and lifestyle changes
• Exploring the use of health coaching in promoting behavior change and improving health outcomes
• Investigating the role of spirituality in promoting mental and physical health
• Examining the effectiveness of school-based policies in promoting healthy lifestyles
• The role of nursing in promoting healthy relationships and preventing intimate partner violence
• Investigating the impact of social determinants of health on health behavior and lifestyle changes
• Exploring the use of mobile applications in promoting healthy behaviors and preventing chronic diseases
• Investigating the role of health literacy in promoting healthy behaviors and preventing chronic diseases

Palliative Care

Improving the quality of life of seriously ill patients and their families during end-of-life care is another critical area of nursing research. Nurses can explore different interventions and support programs that can enhance the palliative care experience.

List of Nursing Research Topics: Palliative Care

• The effectiveness of palliative care on improving quality of life for cancer patients
• Understanding the needs and experiences of family caregivers in palliative care
• Palliative care and end-of-life decision-making: exploring patient and family preferences
• Optimizing the clarifying diagnosis of stomach cancer
• Improving access to palliative care for patients in rural areas
• The role of spirituality in palliative care for terminally ill patients
• Investigating the impact of music therapy on patients receiving palliative care
• Developing effective communication strategies for discussing end-of-life care with patients and families
• Exploring the experiences and needs of patients with non-cancer diagnoses in palliative care
• The impact of nurse-led interventions in improving the quality of life for patients in palliative care
• Evaluating the training needs of nurses in delivering end-of-life care
• The role of nursing in managing symptoms and side effects in palliative care patients
• Strategies for improving communication between nurses and families during end-of-life care
• Assessing the ethical considerations and challenges faced by nurses in palliative care settings
• Evaluating the effectiveness of home-based palliative care programs
• Palliative care for pediatric patients: understanding unique challenges and opportunities
• The impact of cultural and ethnic differences on palliative care provision
• Investigating the role of social support in palliative care for older adults
• The effectiveness of advance care planning in improving end-of-life care
• Understanding the experiences and needs of patients with neurological diseases in palliative care
• Exploring the impact of palliative care on reducing healthcare costs
• Investigating the role of complementary therapies in palliative care
• Improving symptom management in palliative care through medication optimization
• Palliative care and spiritual care: exploring the intersection of these two domains
• The impact of palliative care on reducing hospital readmissions
• Investigating the role of occupational therapy in palliative care
• Developing effective pain management strategies for patients receiving palliative care
• Understanding the experiences and needs of patients with heart failure in palliative care
• The role of pet therapy in improving quality of life for patients in palliative care
• Investigating the impact of palliative care on reducing caregiver burden
• Understanding the experiences and needs of patients with lung disease in palliative care
• Exploring the impact of palliative care on reducing healthcare utilization
• Investigating the role of nutrition in palliative care for patients with cancer
• Understanding the experiences and needs of patients with kidney disease in palliative care
• Improving palliative care for patients with dementia: exploring unique challenges and opportunities
• The role of art therapy in improving quality of life for patients in palliative care
• Investigating the impact of palliative care on reducing emergency department visits
• Developing effective communication strategies for discussing end-of-life care with patients with cognitive impairment
• Understanding the experiences and needs of patients with liver disease in palliative care
• Palliative care for patients with substance use disorders: unique challenges and opportunities
• Investigating the role of physiotherapy in palliative care
• The effectiveness of psychotherapy in improving mental health outcomes for patients in palliative care
• Understanding the experiences and needs of patients with multiple chronic conditions in palliative care
• Improving symptom management in palliative care through non-pharmacological interventions
• Investigating the impact of palliative care on reducing healthcare disparities
• Palliative care and medical aid in dying: exploring ethical and legal considerations

Healthcare Disparities

Studying the factors that contribute to healthcare disparities between different populations and identifying strategies to address these disparities is an important area of nursing research. Nurses can examine the role of social determinants of health in healthcare disparities and propose solutions to improve access and equity in healthcare.

List of Nursing Research Topics: Healthcare Disparities

• Examining the relationship between socioeconomic status and healthcare disparities
• Investigating the impact of implicit bias on healthcare disparities
• Analyzing the impact of racial and ethnic disparities on health outcomes
• Identifying disparities in access to preventative care among different populations
• Exploring the impact of language barriers on healthcare disparities
• Investigating the impact of discrimination on healthcare outcomes
• Identifying disparities in health insurance coverage and access to healthcare services
• Exploring the importance of national health insurance for socioeconomic growth
• Analyzing the impact of geographic location on healthcare disparities
• Evaluating the role of nursing in addressing healthcare disparities in underserved communities
• The impact of socioeconomic factors on patient outcomes and nursing interventions
• Strategies for nurses to promote health equity in diverse patient populations
• Assessing the influence of cultural competence on reducing healthcare disparities
• The role of nursing advocacy in shaping policies to reduce health inequities
• Examining disparities in mental health care access and utilization
• Investigating disparities in maternal and child health outcomes
• Exploring the relationship between healthcare disparities and chronic disease outcomes
• Identifying disparities in end-of-life care and hospice utilization
• Analyzing the impact of cultural differences on healthcare outcomes
• Investigating disparities in healthcare provider communication and patient engagement
• Examining the impact of healthcare policy on healthcare disparities
• Global health learning in nursing and health care disparities
• Identifying disparities in healthcare access and utilization among the LGBTQ+ community
• Exploring the impact of environmental factors on healthcare disparities
• Analyzing the impact of social determinants of health on healthcare disparities
• Investigating disparities in healthcare access and utilization among rural populations
• Examining disparities in healthcare access and utilization among urban populations
• Identifying disparities in healthcare access and utilization among immigrants and refugees
• Analyzing the impact of education level on healthcare disparities
• Investigating disparities in healthcare access and utilization among older adults
• Examining disparities in dental health access and utilization
• Identifying disparities in mental health treatment and access to services
• Analyzing the impact of stigma on healthcare outcomes for marginalized populations
• Investigating disparities in healthcare access and utilization among incarcerated populations
• Exploring disparities in healthcare access and utilization among individuals with disabilities
• Analyzing the impact of institutional racism on healthcare disparities
• Investigating disparities in healthcare access and utilization among low-income populations
• Examining disparities in cancer screening and early detection
• Identifying disparities in access to clinical trials and experimental treatments
• Analyzing the impact of the digital divide on healthcare disparities
• Investigating disparities in healthcare access and utilization among veterans
• Exploring the impact of healthcare worker bias on healthcare disparities
• Examining the relationship between healthcare disparities and infant mortality rates
• Identifying disparities in healthcare access and utilization among people with limited English proficiency
• Analyzing the impact of gender on healthcare disparities
• Investigating disparities in healthcare access and utilization among individuals experiencing homelessness
• Exploring the impact of COVID-19 on healthcare disparities among different populations

Patient-Centered Care

Enhancing patient-centered care, including patient feedback, patient-centered communication, and patient education, is another vital area of nursing research. Nurses can investigate the impact of patient-centered care on patient outcomes and identify ways to incorporate patient preferences and values in the care process.

List of Nursing Research Topics: Patient-Centered Care

• The importance of patient-centered care in improving health outcomes
• Exploring the effectiveness of patient-centered communication in clinical practice
• Assessing patient satisfaction with patient-centered care
• The impact of nursing staffing on patient-centered care
• The role of family and caregiver involvement in patient-centered care
• The use of technology to enhance patient-centered care
• Patient education and empowerment in promoting patient-centered care
• The role of nurses in facilitating shared decision-making in patient care
• Evaluating the impact of personalized care plans on patient outcomes and satisfaction
• Strategies for nurses to engage patients in their care across diverse cultural backgrounds
• The influence of effective communication strategies on the delivery of patient-centered care
• Assessing the barriers and facilitators to implementing patient-centered care in various healthcare settings
• The impact of culture on patient-centered care
• Measuring the quality of patient-centered care in healthcare settings
• The benefits of interdisciplinary collaboration in patient-centered care
• Understanding home dialysis: benefits, barriers, and impacts on elderly patients and the healthcare system
• Addressing language barriers in patient-centered care
• Exploring the challenges of implementing patient-centered care in healthcare organizations
• The role of patient-centered care in reducing healthcare costs
• The impact of patient-centered care on patient safety
• The importance of patient-centered care for vulnerable populations
• The role of leadership in promoting patient-centered care
• Evaluating the impact of patient-centered care on healthcare outcomes
• Examining the effectiveness of patient-centered care in chronic disease management
• The impact of patient-centered care on patient adherence to treatment
• The importance of patient-centered care in pediatric healthcare settings
• The use of patient feedback to improve patient-centered care
• Pediatric oncology: working towards better treatment through evidence-based research
• The role of patient-centered care in addressing health disparities
• Patient-centered care in end-of-life and palliative care settings
• The role of healthcare professionals in promoting patient-centered care
• The impact of patient-centered care on healthcare provider job satisfaction
• The importance of patient-centered care in emergency and critical care settings
• The use of simulation-based training to enhance patient-centered care
• The impact of patient-centered care on patient experience and engagement
• The role of healthcare policy in promoting patient-centered care
• Addressing the needs of patients with complex medical needs in patient-centered care
• The role of the nursing profession in promoting patient-centered care
• Patient-centered care in mental health and psychiatric settings
• The impact of patient-centered care on healthcare provider burnout
• The role of patient-centered care in promoting shared decision-making
• Examining the effectiveness of patient-centered care in rural healthcare settings
• The impact of patient-centered care on patient quality of life
• The use of patient-centered care in managing acute and chronic pain
• Addressing the needs of elderly patients in patient-centered care
• The impact of patient-centered care on healthcare system performance
• Promoting patient-centered care through the use of standardized patient education materials

Nursing Education

Exploring innovative approaches to nursing education and training, such as simulation-based learning and online learning, is a growing area of nursing research. Such research can help identify effective ways to prepare nursing students for their future roles in the healthcare system.

List of Nursing Research Topics: Nursing Education

• The impact of simulation-based training on nursing education outcomes
• The effectiveness of online learning in nursing education
• Innovative approaches to clinical teaching in nursing education
• The role of technology in nursing education
• Student perceptions of nursing education and their impact on learning outcomes
• The impact of cultural competence training on nursing students’ attitudes and behaviors
• The effectiveness of peer-led teaching in nursing education
• Best practices for incorporating interprofessional education into nursing curricula
• The role of reflective practice in nursing education
• The effectiveness of flipped classroom models in nursing education
• The impact of virtual reality and augmented reality tools in nursing education
• Evaluating the effectiveness of online vs. traditional classroom nursing education
• Strategies for enhancing interprofessional education in nursing curricula
• The role of continuous professional development in enhancing nursing competencies
• Assessing the influence of mentorship programs on nursing student success and retention
• Transforming advanced nursing practice: embracing IOM recommendations and higher education
• The impact of mentorship on nursing students’ learning and professional development
• The use of team-based learning in nursing education
• The effectiveness of hands-on skills training in nursing education
• Student perceptions of clinical experiences in nursing education
• The impact of service learning on nursing students’ attitudes and behaviors
• The role of cultural humility in nursing education
• The effectiveness of blended learning in nursing education
• Best practices for incorporating patient-centered care into nursing curricula
• The impact of standardized patient encounters on nursing education outcomes
• Importance and application of patient education technology in healthcare
• The use of case-based learning in nursing education
• The role of faculty development in improving nursing education outcomes
• The effectiveness of clinical reasoning strategies in nursing education
• The impact of nursing education on patient outcomes
• The role of simulation in teaching critical thinking in nursing education
• Best practices for incorporating evidence-based practice into nursing curricula
• The use of gamification in nursing education
• The effectiveness of problem-based learning in nursing education
• The impact of nursing education on student stress and burnout
• The role of intercultural competence in nursing education
• The effectiveness of collaborative learning in nursing education
• The impact of teaching communication skills in nursing education
• Best practices for incorporating patient safety into nursing curricula
• The role of interprofessional collaboration in nursing education
• The effectiveness of clinical coaching in nursing education
• The impact of teaching teamwork skills in nursing education
• The use of high-fidelity simulation in nursing education
• The role of experiential learning in nursing education
• Best practices for incorporating leadership development into nursing curricula
• The impact of nursing education on student retention and graduation rates
• The effectiveness of self-directed learning in nursing education

Healthcare Policy

Studying the impact of healthcare policy on the nursing profession and patient outcomes, including the role of nursing in healthcare reform efforts, is a crucial area of nursing research. Nurses can examine the policy’s effect on healthcare access, quality, and affordability and propose solutions to address policy gaps and challenges.

List of Nursing Research Topics: Healthcare Policy

• The impact of the affordable care act on the nursing profession
• Exploring healthcare informatics: evolution, challenges, and solutions
• The role of nursing in healthcare reform efforts
• The impact of medicare and Medicaid on nursing practice
• The impact of private insurance on nursing practice
• The impact of healthcare policies on nursing workforce development
• Combating workplace violence in nursing: the impact of policies, legislation, and organizational culture
• The role of nursing in healthcare policy decision-making
• The impact of healthcare policies on patient outcomes
• The role of nurses in implementing healthcare policies
• The implications of universal healthcare policies on nursing roles and responsibilities
• Evaluating the impact of health insurance reforms on nursing care delivery
• Strategies for nurses to influence healthcare policy decisions at the national and state levels
• The role of nursing in shaping policies related to patient rights and autonomy
• Assessing the influence of healthcare policy on nursing education and licensure requirements
• Evaluating the impact of nurse advocacy on shaping health policies at local and national levels
• Strategies for nurses to stay updated on changing healthcare policies and their implications
• The role of nursing in shaping policies related to electronic health records and patient privacy
• Assessing the implications of global health policies on nursing practices and education
• The influence of healthcare policies on the scope of practice for advanced practice nurses
• The impact of healthcare policies on nursing education and training
• The impact of healthcare policies on nurse staffing ratios
• The impact of healthcare policies on patient satisfaction
• Understanding the impact of the American Healthcare System Regulatory Acts
• The impact of healthcare policies on healthcare costs
• The impact of healthcare policies on healthcare disparities
• The role of nursing in advocating for healthcare policy changes
• The impact of healthcare policies on patient safety
• The impact of healthcare policies on nursing job satisfaction
• Understanding the US. Health Care Reform: necessity, challenges, and implementation
• The impact of healthcare policies on nursing burnout
• The impact of healthcare policies on nursing retention rates
• The impact of healthcare policies on nursing leadership
• The role of nursing in shaping healthcare policies
• The impact of healthcare policies on healthcare quality
• Workplace violence in healthcare: causes, regulations, and prevention strategies
• The impact of healthcare policies on nursing productivity
• The impact of healthcare policies on healthcare access
• The impact of healthcare policies on nursing workload
• The impact of healthcare policies on nursing autonomy
• The impact of healthcare policies on nursing scope of practice
• The impact of healthcare policies on nursing professional development
• The impact of healthcare policies on nursing research
• The role of nursing in developing healthcare policies
• Massachusetts Health Reform Act: striving for universal coverage and controlled costs
• The impact of healthcare policies on nursing career advancement
• The impact of healthcare policies on nursing licensure and certification
• The impact of healthcare policies on nursing accreditation
• The impact of healthcare policies on nursing ethics
• The impact of healthcare policies on nursing professionalism
• The role of nursing in healthcare policy implementation and evaluation
• The impact of healthcare policies on nursing informatics
• The impact of healthcare policies on nursing diversity and inclusion
• The impact of healthcare policies on nursing practice in rural areas
• The impact of healthcare policies on nursing practice in underserved communities
• The impact of healthcare policies on international nursing practice

The Importance of Research in Nursing

Research is the bedrock of nursing practice. It provides evidence-based knowledge that informs clinical decision-making, enhances patient outcomes, and advances the nursing profession. For nursing students, engaging in research activities offers several benefits:

• Enhanced Clinical Practice

Evidence-based research provides nurses with the latest knowledge and techniques to deliver optimal patient care. It bridges the gap between theoretical learning and practical application, ensuring that patients receive the most current and effective treatments.

• Professional Development

Engaging in research sharpens critical thinking and analytical skills. It fosters a culture of continuous learning, allowing nurses to stay updated with the ever-evolving medical field.

• Contribution to the Field

By conducting research, nurses contribute to the larger body of knowledge in healthcare. Their findings can lead to improvements in patient care, the development of new interventions, or changes in healthcare policies.

• Enhanced Patient Outcomes

Research equips nurses with the knowledge to educate patients, advocate for their needs, and make informed decisions. This ensures better health outcomes and improved patient satisfaction.

• Career Advancement

For those looking to advance in their careers, research can open doors to academic positions, leadership roles, or specialized fields within nursing.

Tips for Selecting a Suitable Research Topic

• Align with Interests

Choose a topic that genuinely interests you. This will keep you motivated throughout the research process.

• Relevance to Current Trends

Consider current trends and challenges in healthcare. Addressing contemporary issues can make your research more impactful.

• Feasibility

Ensure that you have access to the necessary resources and tools to conduct your research. This includes access to participants, equipment, and relevant literature.

It’s essential to choose a topic that’s neither too broad nor too narrow. A well-defined research question will guide your study and ensure it’s manageable.

• Seek Guidance

Don’t hesitate to seek advice from mentors, professors, or professionals in the field. Their insights can help refine your topic and provide valuable direction.

In conclusion, research is a vital component of the nursing profession, driving innovation and ensuring the best patient outcomes. For nursing students and professionals, engaging in research is not only a pathway to academic and career success but also a means to contribute meaningfully to the betterment of patient care.

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Table of content

Crafted with Care:

Nursing Essays!

Precision, Passion, & Professionalism in Every Page.

• OJIN Homepage
• Table of Contents
• Volume 23 - 2018
• Number 2: May 2018
• Evidence Psychiatric Mental Health Interventions

Evidence for Psychiatric and Mental Health Nursing Interventions: An Update (2011 through 2015)

Dr. Bekhet is an Associate Professor at Marquette University College of Nursing in Milwaukee, WI. She received aBSN and MSN from Alexandria University in Alexandria, Egypt. She received a PhD from Case Western Reserve University (CWRU) in Cleveland, OH. Her clinical experience in psychiatric nursing is with persons having schizophrenia, bipolar disorders, obsessive-compulsive disorders, and depressive disorders. She has taught psychiatric mental health nursing to undergraduate and direct entry students. She has also advised PhD students. Dr. Bekhet’s program of research focuses on the effects of positive cognitions and resourcefulness in overcoming adversity in vulnerable populations. Her research has been funded by Sigma Theta Tau International; American Psychiatric Nursing Foundation; International Society of Psychiatric Mental Health Nurses; and Marquette University. She is a past recipient of a Midwest Nursing Research Society Mentorship Grant Award, and has received the Award for Excellence from the CWRU Nursing Alumni Association in 2011 and the Way-Klinger Young Scholar Award from Marquette University in 2012. More recently, she was awarded the 2014 research award from the International Society of Psychiatric Mental Health Nurses. Dr. Bekhet has published numerous articles and presented numerous papers and posters at regional, national, and international conferences.

Dr. Zauszniewski is the Kate Hanna Harvey Professor in Community Health Nursing, and Director of the PhD in Nursing Program at the Case Western Reserve University (CWRU), Cleveland, OH. She received a PhD and MSN from CWRU, Cleveland, OH; a MA in Counseling and Human Services from John Carroll University, Cleveland, OH; a BA in psychology from Cleveland State University, Cleveland, OH; and a diploma in nursing from St. Alexis Hospital School of Nursing, Cleveland, OH. She has practiced nursing for 42 years, including 33 years in the field of psychiatric-mental health nursing; she has experience as a staff nurse, clinical preceptor, head nurse, supervisor, patient care coordinator, nurse educator, and nurse researcher, and is board certified by the American Nurses Credentialing Center (ANCC). Her program of research focuses on the identification of factors and strategies to prevent depression and to preserve healthy functioning across the lifespan. She is best known for her research examining the development and testing of nursing interventions to teach resourcefulness skills to family caregivers. She has received research funding from the National Institutes of Nursing Research and Aging; the National Institutes of Health; Sigma Theta Tau International; the American Nurses Foundation; Midwest Nursing Research Society; and the State of Ohio Board of Regents.

Denise Matel-Anderson is a doctoral student at Marquette University College of Nursing in Milwaukee, WI. She holds an Advanced Practice Nurse Prescriber license, and is currently working on a PhD in nursing with a focus on mental health. She has three publications in mental health nursing journals. Ms. Matel-Anderson currently lectures at Carroll University, Waukesha, WI, in the undergraduate mental health nursing theory course, and serves as a nurse practitioner on the medical team at an acute mental health facility.

Jane Suresky is an Adjunct Assistant Professor at the Frances Payne Bolton School of Nursing of Case Western Reserve University (CWRU) in Cleveland, OH. She has received DNP and MSN degrees from CWRU, and a BSN degree from Cleveland State University, Cleveland, OH. Her clinical experience in psychiatric nursing covers the areas of psychobiological research, adolescent dual diagnosis, and mood disorders. She has taught psychiatric mental health nursing to undergraduate and graduate students. In addition, she has been involved in nursing research that focuses on the stress of the female family members of the severely mentally ill.

Mallory Stonehouse recently graduated with a Master of Science in Nursing degree from Marquette University in Milwaukee, WI, where she completed the adult-older adult, primary care, nurse practitioner program. She is a registered nurse at Froedtert Community Memorial Hospital in Wisconsin, where she works on the Behavioral Health Unit. Ms. Stonehouse holds a Bachelor of Arts degree in psychology.

• Figures/Tables

This state-of-the-evidence review summarizes characteristics of intervention studies published from January 2011 through December 2015, in five psychiatric nursing journals. Of the 115 intervention studies, 23 tested interventions for mental health staff, while 92 focused on interventions to promote the well-being of clients. Analysis of published intervention studies revealed 92 intervention studies from 2011 through 2015, compared with 71 from 2006 through 2010, and 77 from 2000 through 2005. This systematic review identified a somewhat lower number of studies from outside the United States; a slightly greater focus on studies of mental health professionals compared with clients; and a continued trend for testing interventions capturing more than one dimension. Though substantial progress has been made through these years, room to grow remains. In this article, the authors discuss the background and significance of tracking the progress of intervention research disseminated within the specialty journals, present the study methods used , share their findings , describe the intervention domains and nature of the studies , discuss their findings , consider the implications of these studies , and conclude that continued track of psychiatric and mental health nursing intervention research is essential.

Key Words: best practices, evidence-based practice, psychiatric nursing journals, psychiatric nursing research, published research, research dissemination, research utilization, systematic review, tradition, intervention research

Implementation science is concerned with the translation of research into practice... The past five years have seen a rapidly growing interest in the field of implementation science ( Sorensen & Kosten, 2011 ). Implementation science is concerned with the translation of research into practice; it involves the examination of the challenges and the opportunities for successful, evidence-based changes in practice ( Nilsen, 2015 ). Translating research into practice depends heavily on the dissemination of findings from intervention research to those most likely to use those findings in clinical or community settings. In contrast to implementation, dissemination involves the spread of information about an intervention, for example, through publication of the intervention in professional journals. Dissemination strategies that are actively targeted toward spreading evidence-based findings concerning an intervention may prompt future implementation in clinical practice ( Proctor et al., 2009 ).

Translating research into practice depends heavily on the dissemination of findings from intervention research... Important for psychiatric and mental health nurses, it is critical that implementation of evidence-based findings occurs across multiple settings (i.e., beyond specialty mental healthcare units) to medical settings, such as primary care areas in which mental health services are provided, and to non-specialized settings, such as criminal justice and school systems and community social service agencies, where mental healthcare is delivered (Proctor et al., 2009). However, before implementation can happen, dissemination of findings from well-designed intervention studies that can inform psychiatric and mental health nursing practice is needed.

One of the best mediums for disseminating evidence-based findings in psychiatric and mental health nursing is the professional nursing journals that are most available to practicing psychiatric and mental health nurses. Nursing journals that are specifically designed a specialty are more likely to be read by persons in the given specialty area than are other nursing research journals. Nurses in practice settings, including those at an advanced practice level, may not have access to scientific research journals or may choose not to read them if the research does not appear meaningful for their practice. The goal of this review was to describe the findings from intervention studies disseminated through publication in one of the five psychiatric and mental health nursing specialty journals published from 2011 through 2015.

Background and Significance

Through the years, more psychiatric and mental health nurse researchers have been targeting specialty journals for disseminating findings from intervention research. For example, in previous reviews of intervention studies published in the five major psychiatric and mental health specialty journals, there was a higher percentage of quantitative intervention studies conducted from 2006 through 2010 (84%) than in a similar review conducted from 2000-2005 (64%) ( Zauszniewski, Suresky, Bekhet, & Kidd, 2007 ; Zauszniewski, Bekhet, & Haberlein, 2012 ), indicating increased use of more rigorous, statistical analytic methods in published intervention research over time ( Zauszniewski et al., 2007 ; Zauszniewski et al., 2012 ).

Tracking the progress of intervention research disseminated within the specialty journals in psychiatric and mental health nursing is important for two reasons. First, it provides data to show improvements in dissemination efforts of psychiatric and mental health nurse researchers. Second, it calls attention to the importance for continued dissemination of intervention research to practicing psychiatric and mental health nurses who are in the best positions to implement the findings in practice. Therefore, the purpose of this review of the same, five, peer-reviewed psychiatric and mental health nursing journals, covering 2011 through 2015, was to determine the number and types of intervention studies within the specified review period. For consistency, the same criteria for selecting the intervention studies that were described in the previous review ( Zauszniewski et al., 2012 ) were applied: A study was determined to be an intervention study if nursing strategies, procedures, or practices were examined for effectiveness in enhancing or promoting health or preventing disability or dysfunction ( Kane, 2015 ).

Five peer-reviewed nursing journals, regarded as the most frequently read in the mental health nursing profession, were analyzed for the years 2011 through 2015. The journals included in the analysis were Archives of Psychiatric Nursing ; Issues in Mental Health Nursing ; Journal of the American Psychiatric Nurses Associatio n; Journal of Psychosocial and Mental Health Services; and Perspectives in Psychiatric Care .

Journals were reviewed for the type of intervention study (qualitative or quantitative); the study domain (biological, psychological, or social); and the number of intervention studies found within the journals. After review, the agreed upon intervention studies were extracted and individually analyzed by the co-authors.

There were 832 databased articles published from January 2011 through December 2015. However, only 115 (14%) evaluated or tested psychiatric nursing interventions. Of these 115 intervention studies, 14 tested interventions with nursing students, nine involved nurses and mental health professionals, while 92 focused on interventions to promote mental health in clients of care.

This section describes the findings from the 115 intervention studies included in the review. The 23 studies that included nursing students, nurses, and mental health professional, and the 92 that involved recipients of mental health services or care are presented in this section. First, the research settings in which the 115 studies were conducted, and descriptions of the targeted populations are described. Next, the 23 studies’ designs, purposes, and findings are discussed in detail. Third, the 92 studies that involved recipients of mental health services or care are presented using the categories of the bio-psycho-social framework. Finally, the type of data (quantitative, qualitative, or mixed) are discussed and presented in the table.

Research Settings Sixty-six of the 115 intervention studies were completed in the United States. Five studies each were done in Australia and United Kingdom. Four each were completed in Korea, China, and Turkey; three each in Norway, Canada, and Iran; and two each in Taiwan, Mexico, Sweden, France, and Netherlands. One study each was conducted in Jordan, Europe, Iceland, Pacific Islands, Thailand, Spain, Greece, and Singapore

Targeted Populations Fourteen of the 115 intervention studies involved interventions with nursing students, while nine studies focused on nurses and mental health professionals. Ninety-two of the studies examined the effect of the intervention on the client. Examples of the studies describing each of these groups are described below.

Fourteen of the 23 nursing intervention studies involved undergraduate nursing students. Nursing students . Fourteen of the 23 nursing intervention studies involved undergraduate nursing students. One study was conducted in Australia regarding consumer participation ( Happell, Moxham, & Plantain-Phung, 2011 ). In this study, researchers investigated whether education programs introducing nursing students to mental health nursing lead to more favorable attitudes towards consumer participation in the mental health setting after completing the mental health component of the nursing program. Study participants were in the first semester of the final year of the Bachelor of Nursing program. The study used a within-subject design using two points (pre-and post-educational program implementation). Results indicated that students demonstrated positive attitudes toward consumer participation even before completing the mental health component. Only marginal and non-significant changes were noted at the post-test stage. The authors concluded that the findings were not surprising given the positive scores recorded at baseline (ceiling effect) ( Happell et al., 2011 ). Another study investigated the effect of pedagogy of curriculum infusion on nursing students’ well-being and the improvement of quality of patients’ care ( Riley & Yearwood, 2012 ).

Pedagogy of curriculum infusion involves instilling the university values and mission with a focus on educating the whole person, and encouraging faculty to translate the core mission of the university into practice in the classroom. this can be accomplished through a variety of courses that provide students with opportunities for contemplation, reflective engagement, and also action through volunteerism, service, and study abroad. The ultimate goal of the study was to encourage critical thinking through reflective exercises and group discussion. Results indicated that students who have experienced the curriculum infusion showed an ability to be self-advocates when discussing their work challenges. Also, they were able to identify specific nursing actions for patient safety; to recognize the patient as a partner in care; and to demonstrate respect for patients' uniqueness, values, and desires as evidenced by case analysis and personal reflections ( Riley & Yearwood, 2012 ).

Three intervention studies explored simulation to see its impact on improving the learning experiences of the nursing students. Three intervention studies explored simulation to see its impact on improving the learning experiences of the nursing students ( Kameg, Englert, Howard, & Perozzi, 2013 ; Kidd, Knisley & Morgan, 2012 ; Masters, Kane, & Pike, 2014 ). Different simulations were used in the three studies; all of them were deemed effective. For example, the results of the study conducted by Kidd and colleagues indicated that undergraduate, mental health nurs­ing students perceived that Second Life® virtual simulation was moderately effective as an educational strategy and slightly difficult as a technical program ( Kidd et al., 2012 ). Also, second degree and traditional BSN students found that a tabletop simulation, which was developed as a patient safety activity and involved checking-in a patient admitted to a psychiatric care unit, was a good learning experience and helpful to prepare students for situations they may experience in the workplace ( Masters et al., 2014 ). The third study used a high-fidelity, patient simulation (HFPS) to assess senior level nursing student knowledge and retention of knowledge utilizing three parallel, 30-item Elsevier Health Education Systems, Inc. (HESITM) Custom Exams. Although students’ knowledge did not improve following the HFPS experiences, the findings provided evidence that HFPS may improve knowledge in students who are at risk (defined as those earning less than 850 on HESI exam). Students reported that they viewed this simulation as a positive learning experience ( Kameg et al., 2013 ).

An additional intervention study used a quasi-experimental design to explore perceptions of student nurses toward nurses who are chemically dependent, using a two-group, pretest–posttest design (prior to formal education and after receiving substance abuse education). Results indicated that the student nurses in this study had positive perceptions about nurses who are chemically dependent before the intervention; and the education program appeared to reinforce their existing attitudes. ( Boulton & Nosek, 2014 ).

Mitchell et al. ( 2013 ) investigated the impact of an addiction training program for nurses consisting of Screening, Brief Intervention, and Referral to Treatment (SBIRT), and embedded within an undergraduate nursing curriculum, on students’ abilities to apply an evidence-based screening and brief intervention ap­proach for risky alcohol and drug use in their nursing practice. Results indicated that the SBIRT program was effective in changing the undergraduate nursing students’ self-perceptions of their knowledge, skills, and effectiveness in screening and intervening for hazardous alco­hol and drug use. Furthermore, this positive perception was maintained at 30-day follow-up ( Mitchell et al., 2013 ).

Luebbert and Popkess ( 2015 ) investigated the impact of an innovative, active-learning strategy using simulated, standardized patients on suicide assessment skills in a sample of 34 junior and senior baccalaureate nursing students. Additionally, Schwindt, McNelis, and Sharp ( 2014 ) evaluated a theory-based educational program to motivate nursing students to intervene with persons having serious mental illness. Other intervention studies among nursing students focused on improving students' interpersonal relationships; communication competence; empathetic skills; and confidence in performing mental health nursing skills among nursing students ( Choi, Song, & Oh, 2015 ; Choi & Won, 2013 ; Fiedler, Breitenstein, & Delaney 2012 ; Ozcan, Bilgin, & Eracar, 2011 ; Stiberg, Holand, Ostad, & Lorem, 2012 ).

Nursing staff and mental health professionals . Interventions among the nursing staff and mental health professionals accounted for nine of the nursing intervention studies. The majority of these studies were nursing interventions to educate the nursing staff. Educational interventions included: training videos ( Irvine et al., 2012 ); a continuing education course on suicide awareness ( Tsai, Lin, Chang, Yu,& Chou, 2011 ); an education program using simulation ( Usher et al., 2014 ; Wynn, 2011 ); an educational workshop ( White, Hemingway, & Stephenson, 2014 ); training on family-centered care ( Wong, 2014 ); and the impact of the completion of a 26-week trial on nursing staff’s experience for working as a cardio-metabolic health nurse ( Happell et al., 2014 ).

Terry and Cutter ( 2013 ) used a mixed methods pilot study to evaluate the effect of education on confidence in assessing and addressing physical health needs following attendance at a module titled “Physical Health Issues in Adult Mental Health Practice.” The majority of the participants had studied at the university during the previous five years, at either the diploma or the degree level. Results showed improvement in confidence scores for all study participants following the module; participants were able to identify new knowledge and perspectives for practice change.

Results indicated that care zoning increased the nursing team’s capacity to share information and to communicate patients’ clinical needs... Finally, the study conducted by Taylor and colleagues ( 2011 ) used a pragmatic approach to increase understanding of the clinical-risks needs in acute in-patient unit settings. Each patient was classified according to three zoning levels using a traffic light system: red (high level of risk), amber (medium/moderate level of risk), and green (low level of risk). The level of risk was based on multiple factors including clinical judgment and team discussion ( Taylor et al., 2011 ). Results indicated that care zoning increased the nursing team’s capacity to share information and to communicate patients’ clinical needs, as well as to enhance their abilities to address complex clinical presentation and to seek support when needed.

Intervention Domains

Ninety-two of the studies examined the effect of an intervention for the client. In the following section, we will describe the intervention domains of these 92 articles and provided examples. Additional detail is included in the Table .

Interventions in the Biological Domain Eight interventions were in the biological domain. Study interventions included yoga, dancing, diet, medication, electroconvulsive therapy (ECT), exercise, walking, and educational intervention on metabolic syndrome. Four interventions used various kinds of exercises, including walking ( Beebe, Smith, Davis, Roman, & Burke, 2012 ); dancing ( Emory, Silva, Christopher, Edwards, & Wahl, 2011 ); yoga ( Kinser, Bourguigion, Whaley, Hauenstein, & Taylor, 2013 ); and group exercise program ( Stanton, Donohue, Garnon, & Happell, 2015 ). Diet was also used as an intervention. For example, Lindseth, Helland, and Caspers ( 2015 ) used dietary intake of a high or low tryptophan diet as an intervention. Results indicated improvement in patients’ mood, depression, and anxiety for those consuming a high tryptophan diet as compared to those who consumed a low tryptophan diet ( Lindseth et al. 2015 ). A third category within the biological domain was the use of medications as an intervention. One study tested the use of different psychotropic medications for patients diagnosed with schizophrenia ( Zhou et al., 2014 ). A second used ECT as a treatment modality and measured scores on the Montgomery Asberg (MA) Depression Rating Scale before and after the course of treatment ( Pulia, Vaidya, Jayaram, Hayat, & Reti, 2013 ). A final category was an educational program on metabolic syndrome provided to mental health counselors who performed intake assessments on patients newly admitted to two outpatient mental health facilities. ( Arms, Bostic, & Cunningham, 2014 ). Prior to the intervention, neither facility screened for metabolic syndrome at intake or referred patients with a body mass index (BMI) >25 for medical evaluation. Following the intervention, 53 of 132 patients had a documented BMI >25, and 47 of 53 patients were referred to a primary care provider for evaluation. These findings suggested that screening for metabolic syndrome and associated illnesses will increase the rate of detection of chronic conditions ( Arms et al., 2014 ).

Interventions in the Psychological Domain ...the psychological domain had the largest number of intervention studies. Compared to the other domains, the psychological domain had the largest number of intervention studies. Twenty-four of the 92 total intervention studies extracted were in the psychological domain. The intervention studies in the psychological domain included emotion, behavior, and cognition (e.g., counseling) in addition to studies that focused on behavior therapy and psychoeducational programs. Examples of psychological domains studies included: counseling regarding tobacco cessation treatment ( Battaglia, Benson, Cook, & Prochazka, 2013 ); counseling regarding sexual assault ( Lawson, Munoz-Rojas, Gutman, & Siman, 2012 ); resourcefulness training intervention for relocated older adults ( Bekhet, Zauszniewski, & Matel-Anderson, 2012 ); and resilience training and cognitive therapy in women with symptoms of depression aged 18-22 years of age ( Zamirinejad, Hojjat, Golzari, Borjali, & Akaberi, 2014 ) Please see the Table for further details.

One study utilizing an intervention from the psychological domain examined a brief, six- session, cognitive-behavioral intervention among patients with alcohol dependence and depression. The researchers used a quasi-experimental design with a control group and pretest, posttest, and follow-up assessments. Results indicated that the mean depression scores decreased significantly in both the experimental (n = 33) and control groups (n = 27) at the one-month follow-up (Week 7). However, only the experimental group showed significant differences in their mean depression scores between pre- and posttest. At Week 7, the experimental group showed significantly lower mean depression scores than the control group ( Thapinta, Skulphan, & Kittrattanapaiboon, 2014 ).

Interventions in the Social Domain The social domain considers the patients’ environment and its impact on patients’ adjustment and responses to stress. Nine studies involved use of the social domain in their interventions. The social domain considers the patients’ environment and its impact on patients’ adjustment and responses to stress. Interventions in this domain included family, friends, and social support, as well as community interactions ( Zauszniewski et al., 2012 ). One example of an intervention in the social domain involved studying the long-term impact of safe shelter and justice services on abused women’s ability to function after receiving services ( Koci, 2014 ). Another example of an intervention study in the social domain was a pilot, randomized, controlled trial study by Simpson, Quigley, Henry, and Hall ( 2014 ). In this study, the researchers evaluated the selection, training, and support of a group of peer workers recruited to provide support to service users discharged from acute psychiatric unites in London, comparing peer support with usual care ( Simpson et al., 2014 ) (see Table ). A third example in the social domain was designed to help participants successfully transfer from hospitals to the community by enhancing staff participation, creating/maintaining supportive ward milieus, and supporting managers throughout the implementation process ( Forchuk et al., 2012 ).

The study conducted by Horgan, McCarthy, and Sweeny ( 2013 ) was another example of research in the social domain. This study included designing a website for people ages 18-24 who were experiencing depressive symptoms. The website provided a forum to allow participants to offer peer support to each other; it also provided information on depression and links to other supports ( Horgan et al., 2013 ).

Combinations of the Domains Many studies used more than one domain as interventions. Many studies used more than one domain as interventions (see Figure ). Almost half (49%) of the 92 reviewed studies (n = 45) tested an intervention that included two domains. Thirty studies were psychosocial, twelve were biopsychological, and three were biosocial. In addition, six studies (7%) tested intervention with all three domains (biopsychosocial). In the following section, one study from each combination will be described. Again, additional information is provided in the Table .

Figure. Psychiatric Nursing Interventions: Examples of Domains and Their Total Numbers

Iskhandar Shah and colleagues ( 2015 ) studied and tested an intervention from the biopsychological domain using a single-group, pretest–posttest, quasi-experimental research design. Their intervention program included three daily, one-hour sessions incorporating psychoeducation and virtual-reality-based relaxation practice in a convenience sample of twenty-two people with mental disorders. Results indicated that those who completed the program had significantly lowered subjective stress, depression, and anxiety, along with increased skin temperature, perceived relaxation, and knowledge ( Iskhandar Shah et al., 2015 ).

Pedersen, Nordaunet, Martinsen, Berget, and Braastad ( 2011 ) studied an intervention from the biosocial domain. Their intervention program tested the impact of a 12-week, farm-animal-assisted intervention consisting of work and contact with dairy cattle, on levels of anxiety and depression in a sample of fourteen adults diagnosed with clinical depression. The twice-a-week program involved video recording each participant twice during the intervention. Participants were given the choice of either choosing their work tasks with animals (e.g., milking, feeding, hand feeding, moving animals) or the choice of spending their time in contact with farm animals (e.g., patting, stroking, and other non-work-related physical contact). Results indicated that levels of anxiety and depression decreased, and self-efficacy increased during the intervention. Interaction with farm animals (social) via work tasks showed a greater potential for improved mental health than merely animal contact, but only when progress in working skills (biological aspect) was achieved, indicating the role of coping experiences for a successful intervention. ( Pedersen et al., 2011 ).

The NP often accompanied the participant to medical and mental health appointments... Chandler, Roberts, and Chiodo ( 2015 ) conducted a study in the psychosocial domain that examined the feasibility and potential efficacy of implementing a four-week, empower-resilience intervention (ERI) to build resilience capacity with young adults who have identified adverse childhood experiences. The intervention included using mindfulness-based stress reduction (psychological domain) and social support with guided peer and facilitator interaction (social domain). The study randomly assigned a purposive sample of female undergraduate students between the ages of 18 and 24 years of age into two groups: intervention (n = 17) and control (n = 11), and used a pretest–posttest design to compare symptoms, health behaviors, and resilience before and after the intervention program. Results indicated that subjects in the intervention group reported greater building of strengths, reframing resilience, and creating support connections as compared with the control group ( Chandler et al., 2015 ).

Interventions in the biopsychosocial domain include all three components (biological, psychological, and social). There were six studies that included all three domains in their interventions. Hanrahan, Solomon, and Hurford ( 2014 ) used a randomized controlled design to deliver a transitional care model (TCM) intervention to patients with serious mental illness who were transferring from hospital care to home. The intervention group (n = 20) received the TCM intervention delivered by a psychiatric nurse practitioner (NP) for 90 days post hospitalization and the control group (n = 20) received the usual care. The intervention by the nurse practitioner included helping the patients adapt to the home by focusing on managing problem behaviors and physical problems, managing risk factors to prevent further cognitive or emotional decline, promoting adherence to therapies, and integrating physical and mental care approaches. The NP often accompanied the participant to medical and mental health appointments to facilitate communication, translate information to specialty providers, and advocate for the participant ( Hanrahan et al., 2014 ).

Table. Research Classifications by Domains, Design, and Type of Data Used

  Discussion

Although substantial progress is being made to develop and test interventions for persons with psychiatric and mental health challenges and their families, there remains much work to be done. Nurse scientists and practitioners share a professional obligation to persons entrusted to their care, which includes providing the highest quality care grounded in solid empirical evidence ( Willis, Beeber, Mahoney, & Sharp, 2010 ). This review yields evidence for the continued dissemination of findings from intervention studies from 2011 through 2015. To perform the analysis reported here, we employed methods that were similar to those used for amassing information from the intervention studies in two previous reviews ( Zauszniewski et al., 2007 ; Zauszniewski et al., 2012 ) in order to facilitate comparisons over time.

... the continued publication of evidence from countries outside the United States remains important... During the review period (2011-2015), 57% of the published intervention studies took place in the United States (U.S.) while 43% were conducted outside the U.S. (i.e., internationally). These percentages compare with 72% and 54% of published U.S. intervention studies and 28% and 46% published international intervention studies in the 2000-2005 and 2006-2010 reviews, respectively. The somewhat lower percentages (28% and 46%) of international intervention studies within the current time frame (2011-2015) may indicate a need for more descriptive research to identify distinguishing characteristics of international populations and important phenomena that may be amenable to intervention prior to the systematic testing of interventions. However, the continued publication of evidence from countries outside the United States remains important for developing globally relevant interventions for psychiatric nursing practice.

...there have been dramatic increases through the years in the overall number of studies that have tested interventions that tap more than one domain. Of the 115 intervention studies from 2011 through 2015 found in the five journals, nurses, student nurses, nursing staff, or other mental health professionals were the intervention recipients in 23, representing 20% of the intervention studies. This percent is higher than the 14% reported in the previous review conducted from 2006 through 2010, indicating a slightly greater focus on testing interventions in mental health care professionals in recent years. Although the interventions tested in these populations are not focused directly on outcomes for clients with mental health issues, promoting or preserving the mental health of professional caregivers most certainly affects those for whom they provide care.

Analysis of published intervention studies in the 5-year interval from 2011 through 2015 revealed an increase in the number of studies of psychiatric patients or clients in the five selected journals. For this time frame, we found 92 intervention studies in comparison with 71 from 2006 through 2010 and 77 from 2000 through 2005, which reflect 5 and 6-year intervals respectively.

We also noted fewer intervention studies where all three domains were integrated within the intervention... Moreover, there have been dramatic increases through the years in the overall number of studies that have tested interventions that tap more than one domain. For example, 33% of intervention studies from 2011 through 2015 tested psychosocial interventions, compared to 17% in the previous review (2006-2010) and 12% in the one prior to that (2000-2005). In addition, 13% of the studies from 2011 through 2015 tested biopsychological interventions compared with 4% and 5% in the previous two reviews. However, there was a slightly lower percent of biosocial intervention studies, specifically 3% in comparison with 4% from 2000-2005 and 6% from 2006-2010. We also noted fewer intervention studies where all three domains were integrated within the intervention, specifically only 6% in comparison with 17% in the previous time frame (2006-2010). Yet, our review revealed a larger percent of biopsychosocial intervention studies than from the review conducted from 2000-2005 (1%). Despite the lower number of studies that integrated all three intervention domains, there was an overall trend toward testing interventions that were not restricted only to one domain, indicating increased attention toward more holistic interventions.

... the overall trend shows a lesser focus on testing interventions within a single domain over time... There were 41 intervention studies between 2011 and 2015 that focused solely on one domain. With the exception of the biological domain (9%), interventions within the psychological (26%) and social (10%) domains were fewer than in previous reviews. For example, there has been a clear downward trend in the percent of psychological intervention studies over time with 57% from 2000-2005 to 38% from 2006-2010 and 26% in this current review. Intervention studies within the social domain decreased from 17% in 2006-2010 to 10% in this review. Studies of interventions in the biological domain have fluctuated over time from 11% in 2000-2005 down to 1% from 2005-2010 and up to 9% in the review reported here. However, the overall trend shows a lesser focus on testing interventions within a single domain over time, pointing perhaps to a growing interest in determining effective interventions that are multifaceted and target multiple factors that affect a person’s health.

Implications: Research Needed

The mind and body do not function independently of each other; therefore, when considering the focus of nursing research, we need to target both systems. Nursing has as its foundation a holistic approach to patient care. At this point in our history as we build a knowledge base, a multifaceted approach is needed when planning nursing research. This study of nursing interventions in our research has explored the biological, psychological, and social domains. Studies in the biopsychosocial domain would benefit our knowledge base and improve the criteria for more accurate, evidence-based nursing interventions.

Medicine has increasingly focused on the mental health component of medical illnesses. Nursing research would be strengthened by focusing on the possibility of medical illness and its relationship to mental illness. This nursing research approach'‹ would support our holistic philosophy of care and increase our knowledge of the whole person. It would provide the best evidence-based approach to planning treatment. In addition, it would serve to increase the sphere of psychiatric nursing beyond the psychiatric unit in health care settings.

...an increase in multicultural studies is needed to further strengthen our evidenced based practice. Finally, an increase in multicultural studies is needed to further strengthen our evidenced based practice. The individual person is complex. Identified culture provides important information as to how patients view health and illness. This information is an important component when planning our evidenced based care and should not be isolated from the patient presentation.

Tracking the progress in intervention research relevant for psychiatric and mental health nursing practice is essential to identify evidence gaps. This current, systematic review of intervention studies published in the most accessible psychiatric and mental health nursing journals for practicing nurses, educators, and researchers in the United States has revealed a somewhat lower number of studies from outside the United States; a slightly greater focus on studies of nurses, nursing students, or other mental health professionals as compared with clients who receive their care or services; and a continued trend for testing interventions that captured more than one dimension. Tracking the progress in intervention research relevant for psychiatric and mental health nursing practice is essential to identify evidence gaps. Though substantial progress has been made through the years, there is still room to grow.

Abir K. Bekhet, PhD, RN, HSMI Email: [email protected]

Jaclene A. Zauszniewski, PhD, RN-BC, FAAN Email: [email protected]

Denise M. Matel-Anderson, APNP, RN Email: [email protected]

Jane Suresky, DNP, MSN Email: [email protected]

Mallory Stonehouse, MSN, RN Email: [email protected]

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Battaglia, C., Benson, S.L., Cook, P.F., & Prochazka, A. (2013). Building a tobacco cessation telehealth care management for veterans with posttraumatic stress disorder. Journal of the American Psychiatric Nurses Association , 19 (2), 78-91. doi:10.1177/1078390313483314

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May 31, 2018

DOI : 10.3912/OJIN.Vol23No02Man04

https://doi.org/10.3912/OJIN.Vol23No02Man04

Citation: Bekhet, A.K., Zauszniewski, J.A., Matel-Anderson, D.M., Suresky, M.J., Stonehouse, M., (May 31, 2018) "Evidence for Psychiatric and Mental Health Nursing Interventions: An Update (2011 through 2015)" OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2, Manuscript 4.

• Article May 31, 2018 Advancing Scholarship through Translational Research: The Role of PhD and DNP Prepared Nurses Deborah E. Trautman, PhD, RN, FAAN; Shannon Idzik, DNP, CRNP, FAANP, FAAN; Margaret Hammersla, PhD, CRNP-A; Robert Rosseter, MBA, MS
• Article May 31, 2018 Connecting Translational Nurse Scientists Across the Nation—The Nurse Scientist-Translational Research Interest Group Elizabeth Gross Cohn, RN, NP, PhD, FAAN; Donna Jo McCloskey, RN, PhD, FAAN; Christine Tassone Kovner, PhD, RN, FAAN; Rachel Schiffman, RN, PhD, FAAN; Pamela H. Mitchell, RN, PhD, FAAN
• Article May 31, 2018 Translation Research in Practice: An Introduction Marita G. Titler, PhD, RN, FAAN

• Open access
• Published: 19 August 2024

Emotions reflected in colours: experiences of nursing students during the COVID-19 period

• Eda Atay   ORCID: orcid.org/0000-0003-2592-8254 1 ,
• Ezgi Dirgar   ORCID: orcid.org/0000-0001-8214-7441 1 , 2 ,
• Kadiriye Pehlivan   ORCID: orcid.org/0000-0001-8596-5837 1 ,
• Betül Tosun   ORCID: orcid.org/0000-0002-4505-5887 1 , 3 ,
• Ahmet Ayaz   ORCID: orcid.org/0000-0002-4081-2033 1 , 4 ,
• Ayla Yava   ORCID: orcid.org/0000-0003-3468-6779 1 &
• Juan M. Leyva-Moral 1 , 5  

BMC Nursing volume  23 , Article number:  575 ( 2024 ) Cite this article

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Metrics details

The aim of this study was to identify nursing students’ fears and emotions and to concretise the metaphors they used to describe their feelings towards the COVID-19 pandemic.

This study was conducted with nursing students at a foundation university between December 2021 and February 2022 using a sequential mixed methods research design. In the quantitative part of the study, 323 nursing students answered the ‘Positive and Negative Emotion Scale’ and the ‘COVID-19 Fear Scale’. In the qualitative part, students were asked to metaphorise COVID-19 with a colour and 21 in-depth interviews were conducted on the reasons for choosing this colour.

The average age of the students participating in the study was 21.41 ± 1.97 years and 78% of them were female. It was observed that 15.8 of the students had previously tested positive for COVID-19. Most of the participants (98.5%) were vaccinated against COVID-19 and 31.9% had a relative who died due to COVID-19. When the participants were asked which colour they compared COVID-19 to, it was observed that more than half of them chose red (51.4%) among bright colours and 13% chose black among dark colours. In this study, it was determined that students who chose dark colours to describe COVID-19 had higher COVID-19 Fear and Negative Emotion Scale scores. In in-depth interviews, it was observed that students who chose dark colours were more deeply affected by the COVID-19 process, while students who chose light colours associated this period with negative emotions.

In this study, it was observed that nursing students’ feelings and thoughts about the COVID-19 period in line with their experiences affect the choice of colour in metaphorisation.

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Introduction

The COVID-19 pandemic has turned into a social trauma that has deeply affected individuals in many ways, such as in physical, social, economic, and psychological terms [ 1 , 2 ]. The pandemic had devastating effects on society and higher education institutions, nursing education, and clinical learning environments [ 3 ]. Educators have had to move face-to-face online courses, conceptualize, offer alternative clinical experiences, and redefine how student performance is evaluated and graded [ 4 ]. As some students have expressed, the pandemic has deprived them of learning to provide nursing care in this new viral age [ 3 ]. Studies conducted on nursing students have shown that as the duration of social isolation increases, stress and fear increase too; however, psychological problems such as anxiety and depression, and coping behaviors weaken [ 5 , 6 ]. Existing evidence indicates that nursing students felt negatively affected by lockdown during the pandemic, they felt overwhelmed and nervous, and they feared infection and death [ 3 , 7 ]. Examining the emotions of nursing students during the pandemic process is challenging and insufficient when relying solely on standardized measurement tools. In recent years, metaphors have been frequently used to determine individuals’ perceptions of phenomena and events they have encountered [ 8 ]. Therefore, the use of metaphors is a method that can significantly contribute to the in-depth examination of students’ emotions.

Metaphors are defined as tools to explain events and objects using different concepts and representations [ 9 ]. They help associate individuals’ perceptions of events with familiar situational images [ 10 , 11 ]. Metaphors concretize abstract concepts by conveying the events experienced in an emotionally authentic way [ 12 , 13 ]. Thus, they provide an opportunity to reveal how a person interprets experiences and events [ 14 ] and illuminate previously unperceived aspects of phenomena and deepen understanding [ 10 ]. An in-depth examination of nursing students’ feelings towards the pandemic process is crucial in identifying their individual and professional needs and creating strategies to address them. However, there are few studies that deeply examine nursing students’ feelings, thoughts, and experiences related to the pandemic process [ 15 , 16 ].

Emotions such as fear and anxiety experienced by nursing students during the COVID-19 outbreak have mainly been evaluated using quantitative methods [ 5 , 17 ]. Given the complexity of emotions and the inadequacy of standard measurement tools alone, the integration of metaphors can provide richer insights into nursing students’ emotional experiences during the pandemic. Studies have analyzed metaphors to understand the feelings, thoughts, and experiences of various populations working on the front lines during the COVID-19 pandemic [ 2 , 9 , 13 ]. For example, Çakmak et al. (2022) discovered that patients used metaphors like “black hole/dark” for COVID-19 treatment, “steel” for family relationships, and the “sea” for mental health. Fear of death and uncertainty negatively affected family relationships and mental well-being [ 9 ]. Gök & Kara (2022) employed metaphor analysis and identified seven categories: “being restricted,” “restlessness,” “uncertainty/obscurity,” “deadly/dangerous,” “struggling,” “faith/destiny,” and “supernatural.” These categories reflected three themes: “anxiety/concern,” “risk,” and “faith.” In their study aimed at revealing implicit collective emotions related to the COVID-19 pandemic among individuals aged 19 to 79 [ 13 ], Stanley et al. (2021) demonstrated four aligned mental models of the pandemic: (a) uncertainty, (b) danger, (c) grotesque, and (d) misery. According to these mental models, participants’ implicit emotional experiences of COVID-19 converged around several deeply held emotions: (a) grief, (b) disgust, (c) anger, and (d) fear. The study emphasized that these findings have both theoretical and practical implications. It was highlighted that metaphors served to document collective emotions associated with a collective traumatic experience unfolding in real time [ 2 ].

Michel et al. (2021) reported that pandemic stressors harmed students’ well-being and learning, leading to frustration due to limited clinical experiences. Barriers included reduced engagement, poor communication, increased workloads, isolation, learning anxiety, and logistical challenges [ 7 ]. For this reason, it is thought to be important to express the feelings of nursing students, who will serve in the field as health professionals after graduation, about the COVID-19 pandemic through metaphors, including those related to colours, in order to increase the form and quality of nursing education to be provided in a similar pandemic. In addition, it is believed that expressing feelings about the pandemic process will increase both individual and professional resilience and thus the basic step of becoming a qualified healthcare professional will be taken.

Metaphors offer important support for understanding the strong relationships between colour concepts and abstract emotional states [ 18 ]. For instance, it has been published that university students associated the colour red with feelings of energy, love, passion, courage, excitement, danger, and aggression. This association with red can help us understand nursing students’ experiences of intense emotions like passion for their work or the danger and stress they felt during the pandemic. Similarly, the colour blue was associated with feelings of pleasure, comfort, calm, confidence, security, and coldness. This can illustrate moments when nursing students felt calm or secure in their knowledge, as well as times when they might have felt emotionally distant or isolated. The colour yellow, linked with feelings of warmth, joy, hope, optimism, pleasantness, and happiness, can highlight the moments of joy or optimism they experienced, even in challenging times. By using colour metaphors, we can better grasp the nuanced emotional experiences of nursing students during the pandemic, allowing for a more comprehensive understanding of their emotional landscape and helping to inform strategies to support them more effectively in future crises [ 16 ].

Based on the existing literature, this study aims to explore the fears and emotions of nursing students and capture the metaphors they employ to express their sentiments with appropriate themes regarding the COVID-19 pandemic, with a particular focus on the use of colours in these metaphors.

Materials and methods

The study was conducted using an explanatory sequential mixed method research design with nursing students at a foundation university in Turkey between December 2021 and February 2022. This design involves two distinct phases: an initial quantitative phase followed by a qualitative phase to explain and build upon the quantitative results. Specifically, quantitative data was first collected using surveys, and then qualitative data was obtained through focus group interviews to gain deeper insights and explanations related to the survey findings [ 19 ].

Research questions

What are the predominant fears and emotions experienced by nursing students during the COVID-19 pandemic?

How do nursing students use colour metaphors to express their psychological, social, and physical experiences related to the COVID-19 pandemic?

What are the common themes that emerge from the metaphors nursing students use to describe their sentiments towards the COVID-19 pandemic?

Study sample

For the quantitative part of the study, a total of 387 nursing students from a foundation university in Turkey were invited to participate in the study between December 2021 and February2022. The inclusion criteria for this study were to be an actively enrolled undergraduate student in the nursing department in 2021–2022 and to volunteer to participate in the study. Those who did not meet the inclusion criteria were excluded from the study. A sample size of 320 participants was calculated for a 50% heterogeneity, 3% margin error, and a 99% of confidence level. By the end of data collection period 323 valid questionnaires were received (83.46% participation rate). In qualitative research, the quality of the sample is important. For this reason, research is usually conducted with a small number of purposively determined samples. As a result of in-depth interviews, individual interviews are terminated when the data reaches saturation [ 20 ]. For the qualitative part of the study, at least 2 participants representing each of the colours selected in the quantitative part were foreseen, but the final sample size was determined according to data saturation and in-depth interviews were conducted with 21 students.

Data collection process and measurement tools

Sociodemographic data collection.

Sociodemographic details were collected, including participants’ gender, academic year, previous COVID-19 positive diagnosis, COVID-19 vaccine status, chronic diseases, living with, previous family COVID-19 positive diagnosis, and any relative who died because of COVID-19.

Quantitative data collection

Next, quantitative data were collected using the Positive and Negative Affect Scale initially created by Watson et al. (1988) and later validated into Turkish by Gençöz (2000) [ 21 , 22 ]. Then, the COVID-19 Fear Scale, initially created by Ahorsu et al. (2020) [ 23 ] and validated into Turkish by Satıcı et al. (2020), was used [ 24 ].

The Positive and Negative Affect Scale consists of 20 items in two sub-dimensions (10 positive and ten negative emotions). The emotion in each item in the scale is scored between “1 = very little” and “5 = very much.” Each sub-dimension varies between 1 and 50 points. The total score obtained from the sub-dimensions of the scale indicates positive or negative emotional loads. In the Turkish adaptation of the scale, the internal consistency coefficient for positive mood is 0.86, and the internal consistency coefficient for negative mood is 0.83. In this study, the internal consistency coefficient of the positive mood of the scale is 0.86, and the internal consistency coefficient of the negative mood is 0.86.

The COVID-19 Fear Scale consists of seven 5-point Likert type items (1 = strongly disagree, 5 = strongly agree) and one dimension. The scale is scored between 7 and 35, indicating that individuals with high scores have a high fear of COVID-19. In the Turkish adaptation of the scale, the Cronbach’s coefficient of the scale is 0.82. In this study, the Cronbach’s coefficient of the scale is 0.86.

In the last step of the quantitative data collection tool, a triggering question was asked: “With which colour does COVID-19 define/remind/represent you?” This is a single question and not a scale. This question was asked to prepare the ground for the qualitative data collection part of the research and to create a group of students who prefer different colours when selecting the students to be interviewed in the focus group. The students were free to choose colours, and all of the students chose colours without separating them into shades. Then, as a result of the in-depth interviews, the colour choices and expressions of the students according to the answers were evaluated by the researchers, and the participants were divided into two groups (dark and light colours). Six participants were purposively selected from 67 students expressing dark colours (black, grey, or purple) and 21 participants were purposively selected from 256 students expressing bright colours (white, orange, blue, or green).

Qualitative data collection

Open-ended questions were used for the qualitative part. Interviews were conducted face-to-face in a safe and quiet room at the university. All interviews were audio recorded and transcribed verbatim immediately after. To encourage anonymity, students were referred to as Participant 1, Participant 2 instead of using their personal information. Interviews lasted approximately 35 min and were performed by a researcher with proven experience performing qualitative interviews. The script of the interview was created by the researchers in line with the literature [ 5 , 19 ], and it was approved using discussion and consensus techniques with all the research members and two experts from the Department of Guidance and Psychological Counseling and the Psychology Department.

The interview included five open-ended questions:

“How did the COVID-19 pandemic affect you psychologically?“

“How did the COVID-19 pandemic affect you socially?“

“How did the COVID-19 pandemic affect you physically?“

“What is the most intense feeling you feel in the COVID-19 pandemic?“

“What is the reason for choosing the colour … for what COVID-19 makes you feel?”

Data analysis

Quantitative data was analyzed using descriptive and inferential statistics with the support of the software IBM SPSS Statistics for Windows, Version 23.0. Spearman Correlation Analysis Test was used to investigate the relationship with continuous variables. Statistical significance was set at a p-value < 0.05.

Qualitative data was analyzed using the Metaphor Identification Procedure (MIP) with the support of MAXQDA 22 software. Below are the stages suggested by MIP:

Read the entire text to form a general understanding of the meaning.

The words in the text are determined.

a. It determines how the meaning of each word in the text applies to an entity, relationship, or attribute in context. The words that come before and after the determined word are taken into account.

Determine if each word has a more basic meaning out of context.

If the word has a more basic meaning in other contexts than the given context, the contextual meaning is compared with the basic meaning and it is examined whether it contradicts.

If yes, that word is marked as a metaphor [ 20 ]. At the beginning of the form, a written instruction containing explanations was provided to help students understand the concept of metaphor. Students were first asked to generate a colour metaphor to describe COVID-19, and then they were asked to explain in detail the reasons for their selected metaphors. In the initial stage, the metaphors were identified and selected. They were read in detail by a researcher to gain insight into the context in which the participants’ metaphors emerged. A total of 23 metaphors produced by the students were considered for evaluation. Based on the evaluation, metaphors that expressed common meanings and showed similarities were grouped together. After grouping, metaphors consisting of positive and negative colours related to the research topic were obtained. The explanatory texts obtained from the research, the generated metaphors, and the themes created by the researcher through analysis were validated and verified for reliability by obtaining expert opinions from two academics. The expert opinions were compared with the researcher’s analyses until consensus was reached.

The emotions expressed by the colours were grouped using the existing literature [ 25 , 26 , 27 , 28 , 29 ]. Dark colours were identified as black, gray, purple colours and bright colours were identified as white, orange, blue, and green. According to AL-Ayash et al. (2016) [ 30 ] and Hemphill (1995) [ 31 ] it was accepted that bright colours elicited mainly positive emotional associations, and dark colours elicited mainly negative emotional associations (Table  1 ).

Ethical considerations

Ethical approval was received from the Hasan Kalyoncu University Faculty of Health Sciences Non-Invasive Research Ethical Board, and permission was received from the universities where the study was conducted (Date:6 December 2021, Decision No:2021/036). All participants were provided with detailed oral and written information about the study. No risks were identified for participating in the study. All participants provided informed consent. All data collected was anonymous and treated confidential. This study was conducted in accordance with the provisions of the Declaration of Helsinki.

Quantitative results

The mean age of the students participating in the study ( n  = 323) was 21.41 ± 1.97 years, and 78% were female. Of the students, 6.2% ( n  = 20) had chronic diseases, and 68.7% lived with their families. It was observed that 15.8% had previously tested positive for COVID-19. Most (98.5%) participants were vaccinated against COVID-19, and 31.9% had a relative who died due to COVID-19 (Table  2 ).

When the answers given to the question of which colour the participants represent COVID-19 to were analyzed, it was determined that more than half of them chose red ( n  = 16, 51.4%), while 16.7% selected green, and 5.9% chose blue among the bright colours for COVID-19. Regarding the selected dark colours, 42 of the participants associated black colour (13%), 17 of them related gray (5.3%), and eight of them related purple (2.5%) with COVID-19 (Table  3 ).

There was no statistically significant relationship between the COVID-19 Fear Scale scores and the Positive Affect sub-dimension. However, it was observed that there was a moderate positive relationship between the scores obtained from the COVID-19 Fear Scale and the scores of the Negative Affect sub-dimension. As the fear of COVID-19 increased, so did the negative emotions of the students ( r  = 0.328, p  = 0.015) (Table  4 ).

Scores of the students in the Positive Affect sub-dimension were similar in terms of the colour group they chose (bright and dark colours) (t = 1.022, p  = 0.30). However, when the mean scores of the Negative Affect sub-dimension were examined, a statistically significant difference was found between the bright and dark-coloured student groups (t = 2.802, p  < 0.001). In addition, the COVID-19 Fear Scale mean scores of the students who preferred dark colours were higher than those who preferred bright colours (t = 2.514, p  = 0.01) (Table  5 ).

Qualitative results

Twenty-one students with age ranged 18–22 were interviewed (14 female). Eight students were in their 4th year, six were in the 3rd year, four were in their 2nd year, and three were in the 1st year. Nursing degree in turkey lasts four years.

Regarding the colours, six students identified COVID-19 with a dark colour (black, gray, and purple), and 15 did so using bright colours (white, orange, blue, and green) group. Nursing students’ perceptions about the COVID-19 process were examined in-depth using the colour metaphor and focusing on physical, psychological, and social factors. These themes were then classified into two positive effects and adverse effects within themselves (Fig.  1 ).

Nursing students’ perceptions of the Covid-19 process, concept map model

Physical factors

Nursing students participating in the study were physically affected at different levels by the COVID-19 pandemic process. The adverse effects of physical factors included changes in existing routines in meeting basic needs, such as excessive nutrition, sleep disturbance, and immobility, as well as new habits like increased digital exposure, disease development, and acquiring COVID-19. The sub-themes of sleep disturbance, immobility, and digital exposure were prominent among the adverse effects. According to the results, these adverse effects were mainly expressed by students who chose dark colours like black, gray, and purple.

“Of course , it caused many sleep irregularities; you play with the phone until 1–2 a.m. , and you get up around 11-noon” (P2 , chose black colour.)

“During the COVID period , we stayed at home during the curfew time. We worked at home , and I also had to study , and I spent the whole time sitting at a desk. My movements were languid. It was difficult to walk; a need to sleep was present all the time” (P17 , chose gray colour).

Nursing students who chose bright colours such as blue, yellow, orange, and white also mentioned the positive effects despite the negative ones related to their experiences in this process. Among the physical factors, the sub-themes of fresh air, nutrition, and sports were evaluated positively. P4, account illustrates the efforts made to adapt to the conditions “ I tried different sports that I could do at home”. “Exercises like Pilates and yoga were activities I could do in calm and quiet environments without going outside.”

Psychological factors

Nursing students were most affected psychologically by the COVID-19 pandemic. They reported negative emotions such as loss/death experiences, uncertainty and pessimism, sadness, and anxiety/fear. These adverse effects were more frequent in students who chose dark colours like black, gray, and purple.

“COVID-19 came down on us like a black cloud; that is , the whole world was affected by it. Black expressed fear for me , a pitch-black dark environment. It is something like death. When you close your eyes , everything is dark” (P1 , chose black colour) .

“I had a panic attack when the first death occurred.” (P12 , chose red colour) .

Another sub-theme was uncertainty about the future. Students expressed the uncertainty created by the pandemic as a negative feeling, particularly concerning the education process, gaining professional knowledge and experience, and its effects on their family and social lives.

“It was our exam week; that is , when I was studying for the exams , the schools being closed suddenly created a feeling of uncertainty in me. Moreover , I did not know what to do. Should I sit down and study? Were the schools going to re-open? Was this going to continue? I had a feeling of uncertainty a lot” (P18 , chose gray colour) .

“…Nursing is an applied profession and due to the pandemic , we couldn’t get clinical practice. Right now I am feeling a lot of uncertainty about my profession. For example , will I be able to get full satisfaction in my profession with the education I have received? For example , since I am currently in the 3rd grade , how much can I learn until the next year? How much can I improve myself? How much can I put into practice? I honestly don’t know” (P7 , chose red colour) .

In addition, P1, who stated that his family had difficult times after being diagnosed with COVID-19 and chose the black colour, referred to the concept of hopelessness accompanying uncertainty, saying:

“I felt like I was in such a vacuum. I felt this period would never end as if we would be constantly exposed to it , and I would continue to live this life continuously.”

Although the COVID-19 pandemic has had many adverse psychological effects on the lives of nursing students, it has also been observed that this process has given them a positive perspective and strengthened their spirituality, awareness of social support systems, and expressions of hope. Notably, these sub-themes are expressed mainly by students who chose bright colours such as white, blue, and orange.

“There was much negativity in us , but I always tried to look at it from the bright side. For example , my father is a workaholic and has a heart condition. Since COVID-19 prevented him from going to work , he had the opportunity to rest” (P5 , chose white colour).

Social factors

The data showed that the COVID-19 pandemic had a comprehensive social impact on nursing students, their families, and friends. The sub-themes of the factors that negatively affected nursing students socially included interpersonal relationships, isolation/constraints, and obstacles encountered in individual activities. Interpersonal relations were discussed broadly, including relations with family, relatives, and friends. Nursing students emphasized a decrease in interaction and sharing with their immediate environment due to measures to maintain physical and social distance and conflicts related to spending extended periods with family during isolation.

“Frankly , tension can be experienced for any reason. In other words , even if there was an event that would not be misunderstood , there was a problem arising from seeing each other all the time” (P16 , chose red colour.)

“I am a person who loves school very much. I loved the school environment , the friendly environment. Unfortunately , the school closed and constantly opened because of the virus. Being away from teachers and friends , being away from school affected me badly because I could not go to school” (P19 , chose purple colour).

Nursing students who chose dark colours like black, purple, and gray, as well as red, were more negatively affected in social aspects during the COVID-19 process. Individual activities were included in the negative factors because the constraints and isolation measures limited students’ ability to engage in social and academic activities, leading to feelings of frustration and loneliness. However, students also mentioned the benefits of academic studies, individual activities, family/friend relationships, and online personal and professional development trainings in the digital environment, which made this period instructive in many ways.

“I am 22 years old , but I spent more time with my family during this period. I think we had our first breakfast at that time. After the prohibitions , I became happier because I spent more time with my parents” (P3 , chose green).

Similarly, participant P16, who thought they had more opportunities for individual activities during the pandemic process and chose the red colour, said, “I took the time to read books. In addition , I watched many foreign series”.

This study showed that COVID-19 had significant physical, psychological, and social effects on nursing students. The results revealed that the negative emotions of nursing students increased as their COVID-19 fears increased, and the negative emotions and fears of COVID-19 were higher in students who described COVID-19 in dark colours. In studies examining colour-emotion associations, negative emotions and experiences are expressed by individuals in dark colours such as black and gray, while positive emotions are expressed in bright colours such as white, pink, and green [ 29 , 31 ]. Black has been associated with fear, sadness, and hatred [ 29 ], while gray has been related to depression, boredom, and disappointment [ 32 ]. During the pandemic, the most intense emotions experienced by the nursing students were fear, sadness, and anxiety [ 5 , 17 ]. In accordance with previous evidence [ 5 , 6 ], this study shows that nursing students’ negative emotions and fears related to COVID-19 were more present in students who defined COVID-19 in dark colours compared to those who chose bright colours.

The study identified fear, sadness, and anxiety as the predominant emotions experienced by nursing students during the COVID-19 pandemic. These emotions were particularly intense for those who associated the pandemic with dark colours. The findings align with previous studies that link dark colours with negative emotions, providing insight into the emotional state of nursing students during this period [ 5 , 17 ].

Those choosing dark colours were more deeply affected physically, socially, and psychologically in the in-depth interviews. This is an expected result considering the prolonged nature of the COVID-19 pandemic, the detailed knowledge nursing students have due to their vocational training, and the fact that the majority of them are young adults [ 7 , 33 , 34 ]. Clarke et al. (2008) stated that bright colours such as blue, green, and white induced low anxiety levels and had relaxing effects on individuals [ 27 ]. In this study, it is observed that nursing students who chose bright colours also had positive experiences despite the negativities faced during this process. Students who chose the colours white, blue, and green reported positive gains during the pandemic.

The study showed that nursing students used colour metaphors to vividly express their psychological, social, and physical experiences related to the COVID-19 pandemic. Dark colours were linked to negative feelings and experiences, whereas bright colours were associated with more positive experiences and outcomes. This use of colour metaphors provided a unique and expressive way for students to communicate their inner states and coping mechanisms.

Some nursing students described COVID-19 in dark colours due to its adverse effects on physical factors, such as nutrition, inactivity, and changes in sleep patterns during the pandemic. Similarly, studies indicate that nutrition and inactivity problems occur due to changes in the habits of university students, such as sleeping and waking up late and the deterioration of sleep quality [ 7 , 35 , 36 ]. The deterioration in meeting basic life needs means that individuals face the risk of degeneration in their health, which is a state of complete well-being in biopsychosocial terms.

The study also determined that the COVID-19 pandemic had adverse social effects, particularly affecting interpersonal relationships and restrictions, on nursing students who chose dark colours. Restrictions experienced during the pandemic made individuals feel at risk and vulnerable [ 13 ], reduced social activities with individuals and social groups, moved communication to the digital environment, and negatively affected interpersonal relationships [ 36 ]. However, WHO (2020) maintained that people are inherently social beings and need each other during such crises. They reported that alternative solutions, such as regular phone calls with family and friends and video conferences, would help bridge the gap created by social distance and restrictions [ 37 ]. Notably, students who stated that their family relations had strengthened and that they efficiently used this period for activities carried out individually and within the family environment associated COVID-19 with bright colours (green, white, orange).

The common themes that emerged from the metaphors used by nursing students included loss/death experiences, uncertainty, pessimism, sadness, and fear. These themes were particularly prevalent among students who described COVID-19 in dark colours. The lack of clear protocols regarding infection control and treatment procedures heightened feelings of fear and alarm caused by uncertainty. Social isolation and restrictions further intensified feelings of panic and anxiety, contributing to the negative emotions associated with dark colours [ 8 , 13 ].

During the COVID-19 pandemic, nursing students frequently expressed themes such as loss/death experiences, uncertainty, pessimism, sadness, and fear. The lack of a clear protocol regarding infection control and treatment procedures increased feelings of fear and alarm caused by uncertainty in individuals. Social isolation and restrictions also led individuals to experience panic by increasing their feelings of intolerance and anxiety towards the process [ 9 ]. As COVID-19 is a global health crisis threatening the entire world, this process is considered the most challenging form of psychological struggle [ 13 ]. This may have contributed to the negative emotions experienced by nursing students who associated COVID-19 mainly with the colours black, gray, and purple. Additionally, nursing students paired COVID-19 with red and associated this period with a sense of alarm. While some studies associate red with positive emotions [ 27 , 28 ], others relate red with anger, hatred, and alarm [ 29 ]. Jonauskaite et al. (2020) stated that individuals’ colour choices are related to universal associations and may differ according to language, culture, geography, and physical environmental conditions [ 29 ]. Therefore, although the pandemic process has positive and negative effects globally, it is considered that nursing students may have associated negative emotions such as danger, alarm status, and fear with the colour red.

The discussion highlights the complex and multifaceted impact of the COVID-19 pandemic on nursing students, emphasizing the need for supportive measures to address their physical, psychological, and social well-being.

Limitations

This study has some limitations that must be considered. First, this study was conducted only with students in the nursing department of a foundation university, and it is possible to obtain different results when a multicenter study is conducted. Since the researchers are faculty members/staff of the university, the students may have felt under pressure in their answers and interviews. Finally, this study was conducted when the pandemic subsided, cases decreased, and students started face-to-face education. Therefore, findings are limited to students’ recollections and expressions.

Conclusions

Nursing students expressed their fears, feelings, and experiences about the COVID-19 pandemic. Metaphors obtained through in-depth interviews have yielded crucial insights into nursing students’ implicit feelings regarding their pandemic experiences. It has been observed that nursing students associating COVID-19 with dark colours are more adversely affected physically, socially, and psychologically, whereas students associating it with bright colours may experience both positive and negative effects. Developing emotional support programs is essential to better understand nursing students’ pandemic experiences and enhance their emotional well-being. These programs should be tailored to meet the unique needs of students during such challenging times and foster a supportive environment.

Comprehensive research based on various colour metaphors should be undertaken to thoroughly investigate and understand different emotional responses and experiences among nursing students. This research will provide valuable insights into how colour associations may impact their coping mechanisms and emotional states. Encouraging interdisciplinary studies is necessary to gain a more holistic understanding of the pandemic’s effects on health sciences students. Collaborative research efforts can help identify commonalities and differences in experiences across disciplines, facilitating the development of targeted support strategies.

It is crucial to prepare emergency action plans for similar crisis periods post-pandemic. These plans should encompass various potential challenges and uncertainties that may arise, ensuring that institutions and individuals are better equipped to handle future crises. Continuous updates to these plans are imperative to adapt to changing circumstances and improve preparedness. By addressing these areas, we can better support nursing students and enhance their ability to cope with current and future challenges, ultimately fostering a more resilient and well-prepared healthcare workforce.

Availability of data and materials

The data that support the findings of this study are available from the authors, but access to these data is restricted to protect the personal information of the participants.

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Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey

Eda Atay, Ezgi Dirgar, Kadiriye Pehlivan, Betül Tosun, Ahmet Ayaz, Ayla Yava & Juan M. Leyva-Moral

Department of Midwifery, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey

Ezgi Dirgar

Faculty of Nursing, Hacettepe University, Ankara, Turkey

Betül Tosun

Department of Guidance and Psychological Counseling, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey

Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Coordinator of the Vulnerability and Health Nursing Research Group (GRIVIS-UAB), Barcelona, Spain

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EA: Conceptualization, Methodology, Formal analysis, Writing - Original Draft, Visualization. ED: Conceptualization, Data curation, Writing- Original draft preparation. KP: Writing - Original Draft, Visualization, Investigation. BT: Methodology, Formal analysis, Writing - Original Draft, Visualization Supervision.AY: Formal analysis, Writing - Original Draft, Visualization. AY: Reviewing and Editing, Visualization, Supervision.JML: Reviewing and Editing, Visualization, Supervision.

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This study was in accordance with the Declaration of Helsinki and approved by Hasan Kalyoncu University Health Sciences Non-Invasive Research Ethics Committee. Written informed consent was obtained after all participants understood the content of the tool and were informed about the research objectives. In addition, the participants explained the procedures on how to keep their records confidential, such as not revealing the identity of the participants, deleting the records and destroying the transcripts six months after the analysis, and ensuring the security of the devices containing the recording files through passwords and encryption. There is no conflict of interest with any person or organization in the study. This research has not received any specific grants from any funding organizations, commercial or non-profit sectors.

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Atay, E., Dirgar, E., Pehlivan, K. et al. Emotions reflected in colours: experiences of nursing students during the COVID-19 period. BMC Nurs 23 , 575 (2024). https://doi.org/10.1186/s12912-024-02256-6

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Chapter 1 Foundational Mental Health Concepts

1.1. introduction, learning objectives.

• Describe basic concepts related to mental health care
• Establish a safe environment for clients, nurses, and other staff
• Discuss psychiatric-mental health nursing and associated standards of care
• Apply principles of patient-centered care while considering client diversity across the life span

Mental health is an important part of everyone’s overall health and well-being. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood to adolescence and through adulthood. [ 1 ] This chapter will provide an overview of mental health, mental illness, and mental health nursing. As with all areas of nursing, when caring for a person with a mental health diagnosis, it is important to focus on patient-centered care and evaluate the effectiveness of care in terms of the highest level of functioning that person is able to achieve.

Reflective Questions

As we begin this chapter, reflect on the following questions:

How do you define mental health?

How do you define mental illness?

How do you differentiate between the two with everyday functioning?

Consider how you communicate with clients. Which therapeutic techniques have you found work best? What interferes with effective communication?

How does ineffective communication impact client care? How can it affect your nursing license or create legal implications?

1.2. MENTAL HEALTH AND MENTAL ILLNESS

Mental health is an essential component of health. The World Health Organization (WHO) defines  health  as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.  Mental health  is a state of well-being in which an individual realizes their own abilities, copes with the normal stresses of life, works productively, and contributes to their community. The promotion, protection, and restoration of mental health is a vital concern of individuals, nurses, communities, and societies throughout the world. [ 1 ]

According to the American Psychiatric Association,  mental illness  is a health condition involving changes in emotion, thinking, or behavior (or a combination of these) associated with emotional distress and problems functioning in social, work, or family activities. [ 2 ] Mental illness is common in the United States. Nearly one in five (19 percent) of adults experience some form of mental illness, one in twelve (8.5 percent) have a substance use disorder, and one in 24 (4 percent) have a serious mental illness. [ 3 ]

Poor mental health increases the risk of chronic physical illnesses, such as heart disease, cancer, and strokes, and can lead to thoughts and intentions of suicide. Suicide is a common symptom associated with mental illness and is the second leading cause of death in Americans aged 15-34. [ 4 ]

View the following YouTube video on WHO’s Special Initiative on Mental Health (2019-2023) [ 5 ]:  WHO Special Initiative on Mental Health (2019-2023)

Mental health continuum.

Mental health fluctuates over the course of an individual’s life span and can range from well-being to emotional problems and/or mental illness as indicated on the  mental health continuum  illustrated in Figure 1.1 . [ 6 ],[ 7 ],[ 8 ]

Mental Health Continuum (Used with permission.)

Well-being  is on the “healthy” range of the mental health continuum in which individuals are experiencing a state of good mental and emotional health. They may experience stress and discomfort resulting from occasional problems of everyday life, but they are able to cope effectively with these stressors and experience no impairments to daily functioning.

On the other end of the mental health continuum are mental health problems where individuals have progressively more difficulty coping with serious problems and stressors. Within this range are two categories: emotional problems/concerns and mental illness. For individuals experiencing emotional problems, discomfort has risen to a level of mild to moderate distress, and they are experiencing mild or temporary impairments in functioning, such as insomnia, lack of concentration, or loss of appetite. As their level of distress increases, they may seek treatment and often start with visiting their primary health care provider.

Emotional problems become classified as “mental illness” when an individual’s level of distress becomes significant, and they have moderate to severe impairment in daily functioning at work, school, or home. Mental illness includes relatively common disorders, such as depression and anxiety, as well as less common disorders such as schizophrenia. Mental illness is characterized by alterations in thinking, mood, or behavior. The term  serious mental illness  refers to mental illness that causes disabling functional impairment that substantially interferes with one or more major life activities. The Americans With Disabilities Act defines  major life activities  as, “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.” [ 9 ] Examples of serious mental illnesses that commonly interfere with major life activities include major depressive disorder, schizophrenia, and bipolar disorder. [ 10 ] Individuals with serious mental illnesses may experience long-term impairments ranging from moderate to disabling in nature, but many can lead productive lives with effective treatment. Roughly half of schizophrenia patients recovered or significantly improved over the long-term, suggesting that functional remission is possible. [ 11 ],[ 12 ]

Mental health providers, such as psychiatrists, psychologists, therapists, social workers, or advanced practice mental health nurses, use the  Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) published by the American Psychiatric Association to assess a client’s signs and symptoms and determine a mental health diagnosis. The manual lists diagnostic criteria including feelings, behaviors, and time frames to be officially classified as a mental health disorder. [ 13 ]

There are more than 200 types of mental illness. People can experience different types of mental health disorders, and different disorders can occur at the same time or vary in intensity over time. Mental illness can be ongoing, occur over a short period of time, or be episodic (i.e., it comes and goes with discrete beginnings and ends). [ 14 ]

Read more information about specific mental health disorders at the Medline Plus  Mental Health and Behavior  webpage.

Assessing dysfunction and impairment.

Mental health disorders have been defined as a type of dysfunction that causes distress or impaired functioning and deviates from typical or expected behavior according to societal or cultural standards. This definition includes three components referred to as dysfunction, distress, and deviance. [ 15 ]

Dysfunction  includes disturbances in a person’s thinking, emotional regulation, or behavior that reflects significant dysfunction in psychological, biological, or developmental processes underlying mental functioning. In other words, dysfunction refers to a breakdown in cognition, emotion, and/or behavior. For instance, an individual experiencing a delusion that they are an omnipotent deity has a breakdown in cognition because their thought processes are not consistent with reality. An individual who is unable to experience pleasure has a breakdown in emotion, and an individual who is unable to leave home and attend work due to fear of having a panic attack is exhibiting a breakdown in behavior. [ 16 ]

Distress  refers to psychological and/or physical pain. Simply put, distress refers to suffering. For example, the loss of a loved one causes anyone to experience emotional pain, distress, and a temporary impairment in functioning.  Impairment  refers to a limited ability to engage in activities of daily living (i.e., they cannot maintain personal hygiene, prepare meals, or pay bills) or participate in social events, work, or school. Impairment can also interfere with the ability to perform important life roles such as a caregiver, parent, or student. [ 17 ]

Deviance  refers to behavior that violates social norms or cultural expectations because one’s culture determines what is “normal.” When a person is described as “deviant,” it means they are not following the stated and unstated rules of their society (referred to as  social norms ). [ 18 ]

Nurses complete and document initial and ongoing assessments of dysfunction, distress, and behavior associated with an individual’s diagnosed mental health disorder. The World Health Organization Disability Assessment Scale (WHODAS) is a tool recommended in the  DSM-5  to assess impairments resulting from mental illness. [ 19 ] The  WHODAS  is a generic assessment instrument that provides a standardized method for measuring health and disability across cultures. [ 20 ] The WHODAS assesses functioning in six domains: cognition, mobility, self-care, getting along, life activities, and participation. [ 21 ]

View the  WHODAS 2.0 webpage.

The Global Assessment of Functioning (GAF) was historically used to rate the seriousness of a mental illness and measure how symptoms affect an individual’s day-to-day life on a scale of 0 to 100. It is an overall (global) measure of how clients are doing and rates psychological, social, and occupational functioning on the continuum from mental well-being to serious mental illness. The higher the score, the better the daily functioning. The GAF was omitted from the  DSM-5  because it had questionable validity and reliability, but some government agencies and insurance companies continue to include it in paperwork to assess client functioning. [ 22 ]

Mental illness is treatable. Research shows that people with mental illness can get better, and many recover completely. [ 23 ] The majority of individuals with mental illness continue to function in their daily lives.  Recovery  refers to a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. [ 24 ] Dimensions that support a life in recovery include the following:

• Health:  Overcoming or managing one’s disease(s), as well as living in a physically and emotionally healthy way
• Home:  Having a stable and safe place to live
• Purpose:  Participating in meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society
• Community:  Enjoying relationships and social networks that provide support, friendship, love, and hope

Early Signs of Mental Health Problems

Mental health problems are common. We all experience problems and stressors from daily living at the milder end of the mental health continuum, and at some point in our lives, we are likely to experience emotional problems or concerns. Mental illness, though less common, is nevertheless a frequent occurrence, and it is estimated that approximately one in five Americans will personally experience a mental illness in their lifetime. [ 25 ],[ 26 ]

Nurses in all care settings must recognize signs and symptoms of diagnosed and undiagnosed emotional and mental health problems in clients. Each mental health disorder has specific signs and symptoms, but common signs of mental health problems in adults and adolescents are as follows [ 27 ]:

• Excessive worrying or fear
• Excessive sad or low feelings
• Confused thinking or problems concentrating and learning
• Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
• Prolonged or strong feelings of irritability or anger
• Avoidance of friends and social activities
• Difficulty understanding or relating to other people
• Changes in sleeping habits or feeling tired and low energy
• Changes in eating habits, such as increased hunger or lack of appetite
• Changes in sex drive
• Disturbances in perceiving reality referred to as hallucinations (i.e., when a person senses things that don’t exist in reality)
• Inability to perceive changes in one’s own feelings, behavior, or personality (i.e., lack of insight)
• Misuse of substances like alcohol, drugs, or prescription medications
• Multiple physical ailments without obvious causes (such as headaches, stomachaches, or vague and ongoing “aches and pains”)
• Thoughts of suicide
• Inability to carry out daily activities or handle daily problems and stress
• Intense fear of weight gain or being overly concerned with appearance

Mental health disorders can also be present in young children. Because children are still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral or complaints of physical symptoms. Behavioral symptoms in children can include the following [ 28 ]:

• Changes in school performance
• Excessive worry or anxiety, for example fighting to avoid going to bed or school
• Hyperactive behavior
• Frequent nightmares
• Frequent disobedience or aggression
• Frequent temper tantrums

View the following YouTube video about warning signs of mental health problems [ 29 ]:  10 Common Warning Signs of a Mental Health Condition

Cultural impact.

Cultural values and beliefs impact how a person views certain ideas or behaviors. In the case of mental health, it can impact whether or not the individual seeks help, the type of help sought, and the support available. Every individual has different cultural beliefs and faces a unique journey to recovery. In general, historically marginalized communities in the United States are less likely to access mental health treatment, or they wait until symptoms are severe before seeking assistance. [ 30 ]

Four ways that culture can impact mental well-being are the following [ 31 ]:

• Cultural stigma.  Every culture has a different perspective on mental health, and most cultures have a stigma surrounding mental health. Mental health challenges may be considered a weakness and something to hide, which can make it harder for those struggling to talk openly and ask for help.
• Describing symptoms.  Culture can influence how people describe or feel about their symptoms. It can affect whether someone chooses to recognize and talk openly about physical symptoms, emotional symptoms, or both. For example, members of the Amish community are typically stoic and endure physical and emotional pain without complaining.
• Community support.  Cultural factors can determine how much support someone gets from their family and community when it comes to mental health. Because of existing stigma, it can be challenging for individuals to find mental health treatment and support.
• Resources.  When looking for mental health treatment, it can be difficult to find resources and treatment options that take into account a specific culture’s concerns and needs.

Nurses can help clients by understanding the role culture plays in their mental health. If potential signs of undiagnosed or poorly managed mental health disorders are present, nurses should make appropriate referrals for further assessment and follow-up.

Read more about cultural diversity and providing culturally responsive care in the “ Diverse Patients ” chapter of Open RN  Nursing Fundamentals .

Causes of mental illness.

Mental health researchers have developed several theories to explain the causes of mental health disorders, but they have not reached consensus. One factor in which they all agree is that an individual is not at fault for the condition, and they cannot simply turn symptoms on or off at will. There are likely several factors that combine to trigger a mental health disorder, including environmental, biological, and genetic factors. [ 32 ]

Environmental Factors

Individuals are affected by broad social and cultural factors, as well as by unique factors in their personal environments. Social factors such as racism, discrimination, poverty, and violence (often referred to as “social determinants of health”) can contribute to mental illness.

Read more about addressing social determinants of health in the “ Advocacy ” chapter of Open RN  Nursing Management and Professional Concepts .

Additionally, it is estimated that 61% of adults have experienced early  adverse childhood experiences (ACEs)  such as abuse, neglect, or growing up in a household with violence, mental illness, substance misuse, incarceration, or divorce. Chronic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. [ 33 ],[ 34 ] See Figure 1.2 [ 35 ] for an image of adverse childhood experiences.

Adverse Childhood Experiences (ACEs)

Individual trauma resulting from an event, series of events, or set of circumstances that is experienced as physically or emotionally harmful can have lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. [ 36 ] Read more about ACEs and addressing individual trauma in the “ Introduction to Trauma-Informed Care ” section of this chapter.

Take the  Adverse Childhood Experiences Questionnaire for Adults  to better understand how previous experiences can affect one’s well-being.

Current stressors such as relationship difficulties, the loss of a job, the birth of a child, a move, or prolonged problems at work can also be important contributory environmental factors. [ 37 ]

Read more about stress in the “ Stress, Coping, and Crisis Intervention ” chapter.

Biological factors.

Scientists believe the brain can have an imbalance of neurotransmitters, such as dopamine, acetylcholine, gamma-aminobutyric acid (GABA), norepinephrine, glutamate, and serotonin, resulting in changes in behavior, mood, and thought. While causes of fluctuations in brain chemicals aren’t fully understood, contributing factors can include physical illness, hormonal changes, reactions to medication, substance misuse, diet, and stress. [ 38 ]

Read more about neurotransmitters and the central nervous system in the “ Psychotropic Medications ” chapter.

Some studies also suggest that depressive and bipolar disorders are accompanied by immune system dysregulation and inflammation. [ 39 ]

There appears to be a hereditary pattern to some mental illnesses. For example, individuals with major depressive disorder often have parents or other close relatives with the same illness. Research continues to investigate genes involved in specific disorders so that treatment can be effectively targeted to the individual. [ 40 ]

View the following YouTube video on causes of mental illness [ 41 ]:  Understanding the Biology of Mental Illness

Who guidelines for mental health care.

It is vital for nurses to protect and promote the mental well-being of all individuals and address the needs of individuals with diagnosed mental disorders. [ 42 ] The World Health Organization (WHO) published the  Mental Health Intervention Guide  for nurses and primary health care providers that provides evidence-based guidance and tools for assessing and managing priority mental health and substance use disorders using clinical decision-making protocols. Essential principles for providing mental health care include promoting respect and dignity for the individuals seeking care; using effective communication skills to ensure care is provided in a nonjudgmental, nonstigmatizing, and supportive manner; and conducting comprehensive assessments. [ 43 ]

Promoting Respect and Dignity

Individuals with mental health and substance use conditions should be treated with respect and dignity in a culturally appropriate manner. Health care professionals should promote the preferences of people with mental health and substance use disorders and support them, their family members, and their loved ones in an inclusive and equitable manner. These are some tips discussed in the WHO  Mental Health Intervention Guide [ 44 ]:

• Treat people with mental health and substance use conditions with respect and dignity.
• Protect confidentiality.
• Ensure privacy.
• Provide access to information and explain the proposed treatment risks and benefits in writing when possible.
• Make sure the person provides consent to treatment.
• Promote autonomy and independent living in the community.
• Provide access to decision-making options.

Don’t:

• Discriminate against people with mental health and substance use conditions.
• Ignore individual preferences.
• Make decisions for or on behalf of individuals.
• Use overly technical language when explaining proposed treatment.

Using Effective Communication Skills

Using effective communication skills promotes quality mental health care. Tips for effective communication from the WHO  Mental Health Intervention Guide  include the following [ 45 ]:

• Meet the person in a private space, if possible.
• Be welcoming and conduct introductions in a culturally appropriate manner.
• Use culturally appropriate eye contact, body language, and facial expressions that facilitate trust.
• Explain to adults that information discussed during the visit will be kept confidential. (Special considerations regarding “conditional confidentiality” and mandatory reporting for minors are discussed in the “ Childhood and Adolescence Disorders ” chapter.)
• If caregivers are present, suggest speaking with the client alone (except for young children) and obtain consent from the client to share clinical information.
• When interviewing a young person, consider having another person present who identifies with the same gender to maintain feelings of a psychologically safe environment.
• Include the person (and with their consent, their caregivers and family members) in all aspects of assessment and management as much as possible. This includes children, adolescents, adults, and older adults.
• Actively listen. Be empathic and sensitive. (Read more about active listening in the “ Therapeutic Communication and the Nurse-Client Relationship ” chapter.)
• Allow the person to speak without interruption.
• Be patient and ask for clarification of unclear information.
• For children, use language that they can understand. For example, ask about their interests (toys, friends, school, etc.).
• For adolescents, convey that you understand their feelings and situation.
• Always be respectful.
• Be nonjudgmental about an individual’s behaviors and appearances.
• Remain calm and professional.
• Use simple language. Be clear and concise. Avoid medical terminology only understood by health care professionals.
• Use open-ended questions: “Tell me more about what happened?”
• Summarize: “So, your brother pushed you off your bike and then laughed when you fell and started crying?”
• Clarify: “To clarify, were you at home or a neighbor’s house when this happened?”
• Summarize and repeat key points at the end of the conversation.
• Allow the person to ask questions about the information provided. For example, “What questions do you have about what we have discussed today?”
• Thank the person for sharing this sensitive information.
• Show extra sensitivity when discussing difficult topics.
• Remind the person that what they tell you will only be shared with the immediate treatment team to provide the best possible care.
• Acknowledge that it may have been difficult for the person to disclose the information.

Therapeutic Relationship

In all nursing care, the therapeutic relationship with the client is essential. This is especially so in psychiatric care, where the therapeutic relationship is considered to be the foundation of client care and healing. [ 46 ] Although nurse generalists are not expected to perform advanced psychiatric interventions, all nurses are expected to engage in compassionate, supportive relationships with their patients and use therapeutic communication as part of the “art of nursing.” [ 47 ]

The nurse-client relationship establishes trust and rapport with a specific purpose. It facilitates therapeutic communication and engages the client in decision-making regarding their plan of care. Read more about therapeutic communication and the nurse-client relationship in the “ Therapeutic Communication and the Nurse-Client Relationship ” chapter.

Conducting Comprehensive Assessments

Clients undergo comprehensive assessments related to their disorder, including mental status examination, psychosocial assessment, physical examination, and review of laboratory results. Specific nursing assessments are further discussed in the “ Application of the Nursing Process in Mental Health Care ” chapter as well in each “Disorder” chapter. Persons with severe mental health and substance use disorders are two to three times more likely to die of preventable disease like infections and cardiovascular disorders, so it is also important for nurses to advocate for the medical treatment of existing physical disorders. [ 48 ]

View the  WHO’s Mental Health Gap Intervention Guide.

1.3. introduction to trauma-informed care.

Many individuals experience trauma during their lifetimes that can have a lasting impact on their mental health.  Trauma  results from an event, series of events, or set of circumstances that are experienced by an individual as physically or emotionally harmful and can have lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being. Events may be human-made, such as war, terrorism, sexual abuse, violence, or medical trauma, or they can be the products of nature (e.g., flooding, hurricanes, and tornadoes). Nurses must keep in mind to not interject their own experiences or perspectives because something minor to them may be major to the client.

It’s not just the event itself that determines if it is traumatic, but the individual’s experience of the event. Two people may be exposed to the same event or series of events but experience and interpret these events in vastly different ways. Various biopsychosocial and cultural factors influence an individual’s immediate response and long-term reactions to trauma. For most individuals, regardless of the severity of the trauma, the effects of trauma are met with  resilience , defined as the ability to rise above circumstances or meet challenges with fortitude. Resilience includes the process of using available resources to negotiate hardship and/or the consequences of adverse events. [ 1 ]

Trauma can affect people of any culture, age, gender, or sexual orientation. Individuals may also experience trauma even if the event didn’t happen to them. A traumatic experience can be a single event, a series of events, or adverse childhood experiences (ACEs). Review information about ACEs in the “ Mental Health and Mental Illness ” section of this chapter. There has been an increased focus on the ways in which trauma, psychological distress, quality of life, health, mental illness, and substance misuse are linked. For example, the terrorist attacks of September 11, 2001, the wars in Iraq and Afghanistan, disastrous hurricanes, and the COVID pandemic have moved traumatic experiences to the forefront of national consciousness. Trauma can affect individuals, families, groups, communities, specific cultures, and generations. It can overwhelm an individual’s ability to cope; stimulate the “fight, flight, or freeze” stress reaction; and produce a sense of fear, vulnerability, and helplessness. [ 2 ]

Read more information about the stress reaction in the “ Stress, Coping, and Crisis Intervention ” chapter.

For some people, reactions to a traumatic event are temporary, whereas other people have prolonged reactions to trauma with enduring mental health consequences, such as post-traumatic stress disorder, anxiety disorder, substance use disorder, mood disorder, or psychotic disorder. Others may exhibit culturally mediated physical symptoms referred to as  somatization , in which psychological stress is expressed through physical concerns such as chronic headaches, pain, and stomachaches. Traumatic experiences can significantly impact how an individual functions in daily life and how they seek medical care. [ 3 ]

Individuals may not recognize the significant effects of trauma or may avoid the topic altogether. Likewise, nurses may not ask questions that elicit a client’s history of trauma. They may feel unprepared to address trauma-related issues proactively or struggle to effectively address traumatic experiences within the constraints of their agency’s policies. [ 4 ]

By recognizing that traumatic experiences are closely tied to mental health, nurses can provide trauma-informed care and promote resilience.  Trauma-informed care (TIC)  is a strengths-based framework that acknowledges the prevalence and impact of traumatic experiences in clinical practice. TIC emphasizes physical, psychological, and emotional safety for both survivors and health professionals and creates opportunities for survivors to rebuild a sense of control and empowerment (i.e., resilience). [ 5 ] TIC acknowledges that clients can be retraumatized by unexamined agency policies and practices and stresses the importance of providing patient-centered care rather than applying general treatment approaches. [ 6 ]

TIC enhances therapeutic communication between the client and the nurse. It decreases risks associated with misunderstanding clients’ reactions or underestimating the need for referrals for trauma-specific treatment. TIC encourages patient-centered care by involving the client in setting goals and planning care that optimizes therapeutic outcomes and minimizes adverse effects. Clients are more likely to feel empowered, invested, and satisfied when they receive TIC. [ 7 ]

Implementing TIC requires specific training, but it begins with the first contact a person has with an agency. It requires all staff members (e.g., receptionists, direct patient-care staff, nurses, supervisors, and administrators) to recognize that an individual’s traumatic experiences can greatly influence their receptivity and engagement with health services. It can affect their interactions with staff, as well as their responsiveness to care plans and interventions. [ 8 ]

View the following YouTube video on trauma-informed approach to health care [ 9 ]:  Dr. Pickens Explains Trauma-Informed Approach

Read more details about trauma-informed care (tic) in the “ trauma, abuse, and violence ” chapter., 1.4. stigma.

Despite a recent focus on mental health in the United States, there are still many harmful attitudes and misunderstandings surrounding mental illnesses that can cause people to ignore their mental health and make it more difficult for them to reach out for help. [ 1 ],[ 2 ]  Stigma  has been defined as a cluster of negative attitudes and beliefs that motivates the general public to fear, reject, avoid, and discriminate against people with mental health disorders. [ 3 ]

It estimated that nearly two-thirds of people with diagnosable mental health disorders do not seek treatment due to the stigma of mental illness. The  U.S. Surgeon General’s Report  in 1999 was a milestone report that sought to dispel the stigma of mental illness and its impact on those seeking care. [ 4 ] The National Alliance on Mental Illness (NAMI) seeks to improve the lives of those with mental illness and reduce stigma through education, support, and advocacy. NAMI encourages people to share their stories to discredit stereotypes, break the silence, and document discrimination. [ 5 ]

Take a quiz in the following box to separate facts from myths about mental illness.

Take the CDC’s  Mental Health Quiz .

However, stigma and negative attitudes toward mental illness can still be found among nurses. A review of nursing literature by Ross and Golder explored negative attitudes and discrimination towards mental illness in the nursing profession. Several studies from a variety of countries indicated that health care professionals can be classified in three categories in relation to stigma, including “’stigmatizers,” “the stigmatized,” and “de-stigmatizers.” “Stigmatizers” refer to nurses in medical settings with stereotypical attitudes towards clients with mental illnesses, psychiatric-mental health nurses, and/or psychiatry. Nurses classified as “the stigmatized” have mental health disorders or perceive stigma regarding their roles as psychiatric-mental health nurses. “De-stigmatizers” actively work to reduce stigma surrounding mental health disorders. The authors found that many nurses share commonly held stereotypical beliefs portrayed in the media. For example, clients with mental health disorders have been portrayed in the media as dangerous, unpredictable, violent, or bizarre, and these portrayals can cause fearful attitudes. Nurses in the studies were also concerned about inadvertently saying or doing “the wrong thing” or “setting off” uncontrollable behavior. Many nurses in general medical settings felt they lacked the skills to confidently and competently manage behavioral symptoms of clients with mental health disorders. The authors of the review reported that nursing literature supports additional mental health education for entry-level nurses and practicing nurses to enhance their knowledge base on mental health. [ 6 ]

Nurses can reduce stigma and advocate for a client’s needs and dignity by establishing a therapeutic nurse-client relationship. A therapeutic nurse-client relationship is essential in all settings, but it is especially important in mental health care where the therapeutic relationship is considered the foundation of client care and healing. Although nurse generalists are not expected to perform advanced psychiatric-mental health nursing interventions, all nurses are expected to engage in compassionate, supportive relationships with their clients. [ 7 ] In fact, in  Nursing: Scope and Standards of Practice (2021) , the American Nurses Association states, “The nursing profession, rooted in caring relationships, demands that nurses reflect unconditional positive regard for every patient.” [ 8 ]

Read more about establishing a therapeutic nurse-client relationship in the “ Therapeutic Communication and the Nurse-Client Relationship ” chapter.

The first step in resolving stigma is to become aware of one’s personal beliefs. Take the survey in the following box to become more aware of your own attitudes and biases toward mental health care.

Take the  Personal Attitudes Survey  (page 8) from the Canadian Mental Health Association.

1.5. boundaries.

Boundaries  are limits we set as individuals that define our levels of comfort when interacting with others. Personal boundaries include limits in physical, sexual, intellectual, emotional, sexual, and financial areas of our lives. Boundaries promote psychological safety in relationships at work, home, and with partners by protecting one’s well-being and limiting the stress response. For example, if you come away from a meeting or conversation with someone feeling depleted, anxious, or tense, consider if your boundaries were crossed. A lack of healthy personal boundaries can lead to emotional and physical fatigue. [ 1 ]

Five major types of personal boundaries include the following [ 2 ]:

• Physical:  Physical boundaries refer to one’s personal space, privacy, and body. For example, some people are comfortable with public displays of affection (hugs, kisses, and hand-holding), while others prefer not to be touched in public.
• Sexual:  Sexual boundaries refer to one’s comfort level with intimacy and attention of a sexual nature. This can include sexual comments and touch, not just sexual acts.
• Intellectual:  Intellectual boundaries refer to one’s thoughts and beliefs. Intellectual boundaries are not respected when someone dismisses another person’s ideas and opinions.
• Emotional:  Emotional boundaries refer to a person’s feelings. For example, an individual might not feel comfortable sharing feelings with another person and prefer to share information gradually over time.
• Financial:  Financial boundaries refer to how one prefers to spend or save money.

When caring for clients with mental health disorders, it is common to notice problems with setting appropriate boundaries. For example, a client experiencing bipolar disorder may exhibit a lack of financial and sexual boundaries. When they are experiencing a manic episode, they may spend thousands of dollars on a credit card over a weekend or have sexual relations with someone they just met. Another example of boundary issues is an individual with a depressive disorder who is treated poorly by their partner but does not leave or assert boundaries because they don’t feel that they deserve to be treated any better.

Nurses must establish professional boundaries with all clients while also maintaining a respectful and caring relationship. Due to their professional role, nurses have authority and access to sensitive information that can make clients feel vulnerable.  A Nurses Guide to Professional Boundaries  by the National Council of State Boards of Nursing (NCSBN) states that it is the nurse’s responsibility to use clinical judgment to determine and maintain professional boundaries. Nurses should limit self-disclosure of personal information and avoid situations where they have a personal or business relationship with a client. The difference between a caring nurse-client relationship and an over-involved relationship can be difficult to discern, especially in small communities or in community health nursing where roles may overlap. In these circumstances, it is important for the nurse to openly acknowledge their dual relationship and emphasize when they are performing in a professional capacity. Signs of inappropriate boundaries include the following [ 3 ]:

• Self-disclosing intimate or personal issues with a client
• Engaging in behaviors that could be interpreted as flirting
• Keeping secrets with a client
• Believing you are the only one who truly understands or can help the client
• Spending more time than is necessary with a particular client
• Speaking poorly about colleagues or your employment setting with the client and/or their family
• Showing favoritism to a particular client
• Meeting a client in settings outside of work
• Contacting a client and/or their family members using social media

Establishing professional boundaries with clients diagnosed with mental health disorders is essential due to the vulnerability of the client population, as well as the behavioral manifestations of some disorders. For safety purposes, nurses and nursing students should keep their last name, home address, personal telephone number, and social media handles private.

View the NCSBN video: “ Professional Boundaries in Nursing .”

Read  a nurse’s guide to professional boundaries   pdf from the national council of state boards of nursing (ncsbn), 1.6. establishing safety.

Suicidal thoughts are a common symptom of mental health disorders and typically resolve with effective treatment. However, despite a recent increased focus on mental health care, there has been no documented decrease of suicide rates in the United States, and suicide remains the tenth leading cause of death in the country. [ 1 ]

Warning Signs of Suicide

Everyone can help prevent suicide by recognizing warning signs of suicide and intervening appropriately. Warning signs of suicide include client statements or nurse observations of the following [ 2 ]:

• Feeling like a burden
• Being isolated
• Increasing levels of anxiety
• Feeling trapped
• Being in unbearable pain
• Increasing substance use
• Looking for a way to access lethal means
• Increasing anger or rage
• Exhibiting extreme mood swings
• Expressing hopelessness
• Sleeping too little or too much
• Talking or posting about wanting to die
• Making plans for suicide

See Figure 1.3 [ 3 ] for five action steps for anyone to take to prevent suicide in someone experiencing suicidal thoughts or ideations. Nurses can educate others to take the following steps if they believe someone may be in danger of suicide [ 4 ]:

Preventing Suicide

• Call 911 if danger for self-harm seems imminent.
• Ask the person if they are thinking about killing themselves. Although asking this question can feel invasive, it is common for individuals with mental health problems to share their thoughts and plans regarding suicide. Asking them about suicide will not “put the idea into their head” or make it more likely that they will attempt suicide. In fact, by responding appropriately, you can help save their life by asking this question.
• Listen without judging and show you care.
• Stay with the person or make sure the person is in a private, secure place with another caring person until you can get further help.
• Remove any objects that could be used in a suicide attempt.
• Call or text 988 to reach the new nationwide Suicide and Crisis Line for a direct connection with compassionate, accessible care and support for anyone experiencing mental health-related distress.

Establishing a Safe Care Environment for Clients

In addition to encouraging these general action steps to prevent suicide, nurses can further prevent suicide by establishing a safe care environment. Establishing a safe care environment is a priority nursing intervention.

Reducing the risk for suicide is one of the National Patient Safety Goals for Behavioral Health Care established by The Joint Commission. New requirements were established in 2020 that apply to patients in psychiatric hospitals, patients being evaluated or treated for behavioral health conditions as their primary reason for care in general hospital units or critical access hospitals, and all patients who express  suicidal ideation  during their course of care. [ 5 ] These requirements include performing an environmental risk assessment, screening for suicidal ideation, assessing suicide risk, documenting risk of suicide, following evidence-based written policies and procedures, providing information on follow-up care on discharge, and monitoring effectiveness of these actions in preventing suicides. These requirements are discussed in further detail in the following subsections. [ 6 ]

Read more about suicide prevention at  Joint Commission’s Suicide Prevention webpage.

Perform environmental risk assessmen.

An  environmental risk assessment  identifies physical environment features that could be used by clients to attempt suicide. Nurses implement actions to safeguard individuals identified at a high risk of suicide from environmental risks, such as continuous monitoring, routinely removing objects from rooms that could be used for self-harm, assessing objects brought into a facility by clients and visitors, and using safe transportation procedures when moving clients to other parts of the hospital.

In psychiatric hospitals and on psychiatric units within general hospitals, additional measures are taken to prevent suicide by hanging by removing anchor points, door hinges, and hooks. The Veteran’s Health Administration showed that the use of a Mental Health Environment of Care Checklist to facilitate a thorough, systematic environmental assessment reduced the rate of suicide from 4.2 per 100,000 admissions to 0.74 per 100,000 admissions. [ 7 ]

Read more about the VA Mental Health at the  Mental Health Environment of Care Checklist (MHEOCC) webpage [ 8 ]

Screen for suicidal ideation with a validated tool.

Clients being evaluated or treated for mental health conditions often have suicidal ideation (i.e., thoughts of killing themselves). Additionally, clients being treated for medical conditions often have coexisting mental health disorders or psychosocial issues that can cause suicidal ideation. Therefore, all patients aged 12 and older admitted for acute health care should be screened for suicidal ideation with a validated tool. An example of a validated screening tool is the Patient Safety Screener. [ 9 ],[ 10 ] View more information about the Patient Safety Screener tool in the following boxes.

Visit the Suicide Prevention Resource Center’s webpage to read more about the  The Patient Safety Screener: A Brief Tool to Detect Suicide Risk [ 11 ]

View the following youtube video on administering the patient safety screener: [ 12 ] the patient safety screener 3, assess suicide risk.

An evidence-based  suicide risk assessment  should be completed on patients who have screened positive for suicidal ideation. Patients with suicidal ideation vary widely in their risk for a suicide attempt depending upon whether they have a plan, intent, or past history of attempts. An in-depth assessment of patients who screen positive for suicide risk must be completed to determine how to appropriately keep them safe from harm. Assessment for suicide risk includes asking about their suicidal ideation (i.e., thoughts of suicide), if they have a plan for committing suicide, their intent on completing the plan, previous suicidal or self-harm behaviors, risk factors, and protective factors. [ 13 ] When assessing for a suicide plan, notice if the plan is specific and the method they plan to use. The risk of acting on suicide thoughts increases with a specific plan. The risk also increases if the plan includes use of a lethal method that is accessible to the client.

An example of an evidence-based suicide risk assessment tool that anyone can use with anyone, anywhere is the Columbia Protocol, also known as the Columbia-Suicide Severity Rating Scale (C-SSRS). Read more about the C-SSRS in the following box. The C-SSRS uses a series of simple, plain-language questions that anyone can ask. The answers help identify if a person is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs. Examples of questions include the following [ 14 ]:

• Have you had thoughts of killing yourself?
• Have you thought about how you might do this?
• Have you done anything, started to do anything, or prepared to do anything to end your life?

Columbia Suicide Severity Rating Scale (C-SSRS) [ 15 ]

Read more about using the C-SSRS at  Columbia Lighthouse Project web site.

View the following YouTube video on C-SSRS [ 16 ] at  Saving Lives Worldwide – A Call to Action – The Columbia Lighthouse Project

Develop a Safety Plan

If a client is assessed as high risk for suicide, a safety plan should be created in collaboration with the client. A  safety plan  is a prioritized written list of coping strategies and sources of support that clients can use before or during a suicidal crisis. The plan should be brief, in the client’s own words, and easy to read. After the plan is developed, the nurse should problem solve with the client to identify barriers or obstacles to using the plan. It should be discussed where the client will keep the safety plan and how it will be located during a crisis. [ 17 ],[ 18 ]

Read the  Safety Planning Guide PDF  by the Western Interstate Commission for Higher Education. [ 19 ]

Document level of risk for suicide.

After suicide screening and suicide risk are assessed, it should be documented and communicated with the treatment team, along with the plan to keep the client safe. It is vital for all health care team members caring for the client to be aware of their level of risk and plans to reduce that risk as they provide care. [ 20 ] Nurses complete documentation regarding the level of a client’s suicide risk and associated interventions every shift or more frequently as needed, depending upon the client status.

Follow Written Policies and Procedures

Nurses must strictly follow agency policies and procedures addressing the care of individuals who are identified at risk for suicide to keep them safe. For example, in some suicide cases reported to The Joint Commission, the root cause was a failure of staff to adhere to agency policies, such as a period of time when one-to-one monitoring was in place for a client identified as high risk for suicide. [ 21 ]

Provide Information for Follow-Up Care on Discharge

Nurses should provide written information at discharge regarding follow-up care to clients identified at risk for suicide and share it with their family members and loved ones as appropriate. Studies have shown that a patient’s risk for suicide is high after discharge from psychiatric inpatient or emergency department settings. Developing a safety plan with the patient and providing the number of crisis call centers can decrease suicidal behavior after the patient leaves the care of the organization. [ 22 ]

Monitor Effectiveness of Suicide Prevention Interventions

The effectiveness of policies and protocols regarding suicide prevention should be evaluated on a periodic basis as part of overall quality improvement initiatives of the agency. [ 23 ] Research demonstrates implementation of the Zero Suicide Model results in lower suicidal behaviors.

Zero Suicide Toolkit [ 24 ]

Read the american psychiatric association  psych news alert , “‘ zero suicide’ practices at mental health clinics reduce suicide among patients “., visit the  zero suicide toolkit webpage., view the following who video on preventing suicide by health care workers [ 25 ]:, establishing a safe care environment for nurses and other health care team members.

The American Nurses Association states, “No staff nurse should have to deal with violence in the workplace, whether from staff, patients, or visitors.” [ 26 ]  Workplace violence  is the act or threat of violence, ranging from verbal abuse to physical assaults directed toward persons at work or on duty. The impact of workplace violence can range from psychological issues to physical injury or even death. Violence can occur in any workplace and among any type of worker, but the risk for nonfatal violence resulting in days away from work is greatest for health care workers. [ 27 ] Research indicates the rate of physical assaults on nurses is 13.2 per 100 nurses per year, and 25% of psychiatric nurses experienced disabling injuries from client assault. Many experts believe these figures represent only the tip of the iceberg and that most incidents of violence go unreported. [ 28 ] See Figure 1.4 [ 29 ] for an illustration of safety first.

Safety First

Safety strategies for nurses and nursing students providing client care include the following [ 30 ]:

• Tuck away long hair so that it can’t be grabbed
• Avoid earrings or necklaces that can be pulled
• Avoid overly tight clothing that can restrict movement or overly loose clothing or scarves that can be caught
• Use breakaway safety lanyards for glasses, keys, or name tags
• Do not wear your stethoscope around your neck
• When in a room with a client or visitor who is demonstrating warning signs of escalation, position yourself between the door and the client so you can exit quickly if needed
• Note exits and emergency phone numbers, especially if you float to other areas
• Recognize that confusion, background noises, and crowding can increase clients’ stress levels
• Be aware that mealtimes, shift changes, and transporting patients are times of increased disruptive behaviors
• Most violent behavior is preceded by warning signs, including verbal cues and nonverbal cues. The greater the number of cues, the greater the risk for violence. Be aware of these verbal and nonverbal cues indicating a client’s potential escalation to violence:
• Speaking loudly or yelling
• Using a threatening tone of voice
• Evidence of confusion or disorientation
• Irritability or easily angered
• Boisterous behavior (i.e., overly loud, shouting, slamming doors)
• Disheveled physical appearance (i.e., neglected hygiene)
• Holding arms tightly across chest
• Clenching fists
• Heavy breathing
• Pacing or agitated restlessness
• Looking terrified (signifying fear and high anxiety)
• Staring with a fixed look
• Holding oneself in an aggressive or threatening posture
• Throwing objects
• Exhibiting sudden changes in behavior or signs of being under the influence of a substance
• Use risk assessment tools to evaluate individuals for potential violence, enabling all health care providers to share a common frame of reference and understanding. This minimizes the possibility that communications regarding a person’s potential for violence will be misinterpreted. These tools can be used as an initial assessment upon admission to determine potential risk for violence and repeated daily to assist in predicting imminent violent behavior within the next 24 hours. See sample risk assessment tools in the box at the end of this section.
• Be aware of your own feelings, responses, and sensitivities and pay attention to your instincts. For example, your “fight or flight” response can be an early warning sign of impending danger to get help or get out.
• Be aware of how you express yourself and how others respond to you. Those who know you well may respond differently than do strangers. Effective therapeutic communication skills are an essential tool in preventing violence.
• Use self-awareness and acknowledge if you have a personal history of abuse, trauma, or adverse childhood experiences (ACEs) that can affect how you respond to situations.
• If coworkers are engaging in abusive behaviors, consider if you are exhibiting similar behaviors.
• Be aware that fatigue can diminish your alertness and your ability to respond appropriately to a challenging situation.
• A key aspect of self-awareness is recognizing how our own particular cultural heritage, values, and belief systems affect how we respond to our clients and coworkers and how they, in turn, respond to us.

Sample Violence Risk Assessment Tools from the CDC:

• Triage Tool PDF
• Indicator for Violent Behavior PDF
• Assault and Homicidal Danger Assessment Tool PDF

If travelling to a home setting as a home health nurse, additional safety strategies are as follows [ 31 ]:

• Review agency files to confirm that a background check was done on a patient regarding any history of violence or crime, drug or alcohol abuse, and mental health diagnoses. Also, check to see if a patient’s family member has a record of violence or arrest.
• If entering a situation assessed as potentially dangerous, you should be accompanied by a team member who has training in de-escalation and crisis intervention.
• Always carry a charged cell phone.
• Make sure someone always knows where you are.
• Have a code word to use with your office or coworkers to let them know you’re in trouble if you can’t call the police.

The CDC offers a free, online course called Workplace Violence Prevention for Nurses to better understand the scope and nature of violence in the workplace. Access the free CDC course on workplace violence with nurse videos at the  Workplace Violence Prevention for Nurses webpage

1.7. psychiatric-mental health nursing, what is psychiatric-mental health nursing.

Registered nurses (RNs) in a variety of settings provide care for clients with medical illnesses who may also be experiencing concurrent mental health disorders. Nurses who specialize in psychiatric-mental health nursing promote clients’ well-being through prevention strategies and patient education, while also using the nursing process to provide care for clients with mental health and substance use disorders. [ 1 ] According to the American Psychiatric Nurses Association, psychiatric-mental health nurse specialists perform the following activities [ 2 ]:

• Partner with individuals to achieve their recovery goals
• Provide health promotion and maintenance
• Conduct intake screening, evaluation, and triage
• Provide case management
• Teach self-care activities
• Administer and monitor psychobiological treatment regimens
• Practice crisis intervention and stabilization
• Engage in psychiatric rehabilitation and intervention
• Educate patients, families, and communities
• Coordinate care
• Work within interdisciplinary teams

Within the specialty of psychiatric-mental health nursing, there is an opportunity to become board certified. Eligibility requirements include a bachelor’s degree, two years of full-time work, 30 hours of continuing education, and passing a certification exam. The nurse earns the credential of PMH-BC (Psychiatric-Mental Health-Board Certified) or RN-BC.

Psychiatric-mental health advanced practice registered nurses (PMH-APRN) and nurse practitioners (PMHNP-BC) are registered nurses with a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree in psychiatric nursing. PMH-APRNs perform the following activities:

• Provide individual, group, couples, and/or family psychotherapy
• Prescribe medication for acute and chronic illnesses
• Conduct comprehensive assessments
• Provide clinical supervision
• Diagnose, treat, and manage chronic or acute illness
• Provide integrative therapy interventions
• Order, perform, and interpret lab tests and other diagnostic studies
• Provide preventative care, including screening
• Develop policies for programs and systems
• Make referrals for health problems outside their scope of practice
• Perform procedures

Standards of Psychiatric-Mental Health Nursing

The American Psychiatric Nurses Association establishes standards of practice in psychiatric-mental health nursing that are built on the ANA Scope and Standards of Practice (2021). These standards are published in the  Psychiatric-Mental Health Nursing: Scope and Standards of Practice  document. [ 3 ] The standards are very similar to the ANA Scope and Standards of Practice, with additional activities included in the  Intervention  standard of care. These interventions will be further discussed in the “ Implementation ” section of the “Application of the Nursing Process in Mental Health Care” chapter.

Read the  About Psychiatric-Mental Health Nursing  webpage to learn more about the American Psychiatric Nursing Association.

There are specific legal and ethical considerations that apply to caring for clients with mental illness. See the “ Legal and Ethical Considerations in Mental Health Care ” chapter for further information.

Treatment Settings

There are many settings where psychiatric-mental health nurses collaboratively provide services to clients with mental health disorders, ranging from outpatient settings to inpatient care to state mental hospitals.

Outpatient Services

Clients often initially visit their primary care provider when concerned about their mental health. If a client has a more severe disorder, they are typically referred to specialized psychiatric care providers such as psychiatrists, psychiatric-mental health advanced practice registered nurses/nurse practitioners, psychologists, social workers, counselors, or other licensed therapists.

There are many different types of mental health services offered in the community:

• Patient-centered medical homes that are comprehensive, coordinated, patient-centered models of primary care. [ 4 ]
• Community mental health centers that offer free, low-cost, or sliding scale care for those who lack funding for mental health care.
• Country programs, such as Comprehensive Community Services (CSC) or Community Support Programs (CSP).
• Psychiatric mental health care in correctional facilities.
• Psychiatric home care that provides community-based treatment for clients who are homebound.
• Certified peer specialists.
• Telepsychiatry that provides therapy and prescription services through videoconferencing. [ 5 ]

Inpatient Care Settings

Clients with acute mental health symptoms, or those who are at-risk for hurting themselves or others, may be hospitalized. They are often initially seen in the emergency department for emergency psychiatric care. Clients may seek voluntary admission, or in some situations, may be involuntarily admitted after referral for emergency evaluation by law enforcement, schools, friends, or family members. Read more about involuntary admissions in the “ Patient Rights ” section of the “Legal and Ethical Considerations in Mental Health Care” chapter.

Acute-care psychiatric units in general hospitals are typically locked units on a separate floor of the hospital with the purpose of maintaining environmental safety for its clients. State-operated psychiatric hospitals serve clients who have chronic serious mental illness. They also provide court-related care for criminal cases where the client was found “not guilty by reason of insanity.” This judgment means the client was deemed to be so mentally ill when they committed a crime that they cannot be held responsible for the act, but instead require treatment. [ 6 ]

Terminology Used in Psychiatric-Mental Health Nursing

Specific terminology is used in psychiatry and mental health nursing to document and describe signs, symptoms, and behaviors related to mental health disorders. Using specific mental health terminology when documenting and communicating with interprofessional health care team members is vital to ensure continuity of care. See the definitions of common terms in the “ Assessment ” section of the “Application of the Nursing Process in Mental Health Care” chapter, as well as in chapters related to specific mental health disorders.

1.8. LEARNING ACTIVITIES

I. GLOSSARY

Traumatic circumstances experienced during childhood such as abuse, neglect, or growing up in a household with violence, mental illness, substance use, incarceration, or divorce.

Limits that we set as individuals that define our levels of comfort when interacting with others. Personal boundaries include limits in physical, sexual, intellectual, emotional, sexual, and financial areas of our lives.

Behavior that violates social norms or cultural expectations because one’s culture determines what is “normal.”

Psychological and/or physical pain.

Disturbances in a person’s thinking, emotional regulation, or behavior that reflects significant dysfunction in psychological, biological, or developmental processes underlying mental functioning.

Identification of physical environment features that could be used to attempt suicide in clients identified as at a high risk for suicide.

A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

A limited ability to engage in activities of daily living (i.e., they cannot maintain personal hygiene, prepare meals, or pay bills) or participate in social events, work, or school.

Activities of daily living such as caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working. [ 1 ]

A state of well-being in which an individual realizes their own abilities, copes with the normal stresses of life, works productively, and contributes to their community. [ 2 ]

A continuum of mental health, ranging from well-being to emotional problems to mental illness.

A health condition involving changes in emotion, thinking, or behavior (or a combination of these) associated with emotional distress and problems functioning in social, work, or family activities. [ 3 ]

A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. [ 4 ]

The ability to rise above circumstances or meet challenges with fortitude. [ 5 ]

A prioritized written list of coping strategies and sources of support that clients can use before or during a suicidal crisis. The plan should be brief, in the client’s own words, and easy to read. After the plan is developed, the nurse should problem solve with the client to identify barriers or obstacles to using the plan. It should be discussed where the client will keep the safety plan and how it will be located during a crisis.

Mental illness that causes disabling functional impairment that substantially interferes with one or more major life activities. Examples of serious mental illnesses that commonly interfere with major life activities include major depressive disorder, schizophrenia, and bipolar disorder. [ 6 ]

Stated and unstated rules of an individual’s society.

A cluster of negative attitudes and beliefs that motivates the general public to fear, reject, avoid, and discriminate against people with mental health disorders.

Thoughts of killing oneself.

Identifying the risk of a client dying by suicide by assessing suicidal ideation, plan, intent, suicidal or self-harm behaviors, risk factors, and protective factors.

An event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful and can have lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being.

A strengths-based framework that acknowledges the prevalence and impact of traumatic experiences in clinical practice. TIC emphasizes physical, psychological, and emotional safety for both survivors and health professionals and creates opportunities for survivors to rebuild a sense of control and empowerment referred to as resilience. [ 7 ]

The “healthy” range of the mental health continuum where individuals are experiencing a state of good mental and emotional health.

The act or threat of violence, ranging from verbal abuse to physical assaults, directed toward persons at work or on duty.

A generic assessment instrument that provides a standardized method for measuring health and disability across cultures.

Licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/ .

• Cite this Page Open Resources for Nursing (Open RN); Ernstmeyer K, Christman E, editors. Nursing: Mental Health and Community Concepts [Internet]. Eau Claire (WI): Chippewa Valley Technical College; 2022. Chapter 1 Foundational Mental Health Concepts.
• PDF version of this title (53M)

In this Page

• INTRODUCTION
• MENTAL HEALTH AND MENTAL ILLNESS
• INTRODUCTION TO TRAUMA-INFORMED CARE
• ESTABLISHING SAFETY
• PSYCHIATRIC-MENTAL HEALTH NURSING
• LEARNING ACTIVITIES

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