Sonja Kuipers

Background/Objectives: Urine drug testing (UDT) is a core component of nursing interventions within the treatment of substance use disorder (SUD). Beyond the detection of psychoactive substance use and medication adherence, UDT also provides opportunities for therapeutic dialogue, patient support, and recovery monitoring. Despite its routine use, little is known about how patients experience UDT and its potential as a therapeutic nursing tool within recovery-oriented care. This study aimed to explore patients’ lived experiences with UDT to understand its role in recovery-oriented addiction treatment. Methods: A phenomenological study with in-depth, semi-structured interviews was conducted among 12 residents of a supervised living facility at Addiction Care North Netherlands. Data were analyzed using Colaizzi’s seven-step method. Results: Four main themes were constructed in relation to trust within the therapeutic relationship—empowerment, accountability, and autonomy. Patients stated that their perception of UDTs as either supportive or punitive depended strongly on the level of trust within the therapeutic relationship. When trust was present, UDTs were experienced as supportive nursing tools that fostered empowerment and positive self-image, reinforced accountability for recovery goals, and upheld autonomy in decision-making. Conversely, in the absence of trust, UDTs were often perceived as punitive, coercive measures that undermined self-confidence and diminished accountability, ultimately hindering recovery progress. Nursing practices that emphasized nonjudgmental interpretation of results, collaborative decision-making, and patient-centered support contributed to positive experiences. Conclusions: Patients’ experiences indicate that the therapeutic value of UDT is highly dependent on the quality of the patient–nurse relationship. Nurses play a key role in ensuring that UDT is used as a supportive intervention rather than merely a control measure. Integrating UDT into holistic, recovery-oriented care can foster engagement, empowerment, and a sense of accountability. Future research should investigate nursing-led strategies to optimize UDT implementation tailored to treatment phase and patient needs.

Eye contact is one of the most important forms of interpersonal communication. Nonetheless, research has shown that there is no gold standard for how eye c

Background/Objectives: Although psychoeducation for relatives of individuals with a first episode psychosis is important for increasing understanding of psychosis, reducing relapse rates, decreasing hospitalization duration, and improving patient functionality, there is limited research on the specific experiences and needs of relatives of patients with a first episode psychosis. This study aims to explore the experiences and needs of relatives of young adults with first-episode psychosis regarding psychoeducation, with the goal of developing tailored psychoeducation (PE) that can be delivered by nurses. Methods: This qualitative study employed a descriptive, interpretative approach with a total sample of 23 participants, including semi-structured interviews (N = 16), two dyadic interviews (N = 4) and one triadic interview (N = 3). The dyadic interviews included two relatives and two patients, while the triadic interview involved two relatives and one patient. A topic list was utilized to guide the interviews. Thematic analysis was employed to analyse the data, supported by the use of ATLAS.ti. Results: During data analysis, five key themes were identified as relevant for the development of a psychoeducational program: experiences with first-episode psychosis and psychoeducation, the content of PE (what), timing (when), exchanging experiences (how) and joint PE versus separate groups (which format). Conclusions: This study highlights valuable insights and key components for an integrated psychoeducation program, focussing on the needs and experiences of relatives, for the development of the PE program. To optimize the benefits for both parties, future research should explore the potential of offering PE sessions that accommodate both individual and combined participant formats, allowing for a design tailored to the specific needs of the participants.

Patients with psychotic disorders frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aimed to develop supportive tools for MHNs regarding oral health to increase sensitisation among MHNs and provide MHNs with the knowledge to recognise (potential) oral health problems in patients with a psychotic disorder. We used a human-centred design in which the user, MHNs and experts by experience were placed at the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problems as well as needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on the context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHNs, and the intended outcomes of tools. A multi-criteria decision matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. The most promising result was the development of a brochure with an awareness screener. The brochure with the awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n = 19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure included a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimise care processes for oral health tools in MHNs should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

Patients with a psychotic disorder frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aims to develop supportive tools for MHNs regarding oral health to increase sensitization among MHNs and to provide MHNs with knowledge to recognize (potential) oral health problems in patients with a psychotic disorder. We used a human-centered design in which the user, MHNs as well as experts by experience, were placed in the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problem as well as the needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHN, and intended outcomes of tools. A Multi Criteria Decision Matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. Most promising result was the development of a brochure with an awareness screener. The brochure with awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder, based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n=19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure include a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimize care processes for oral health tools in MHNs, should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

In mental health, oral health is often given little attention. Mental health nurses (MHNs) are professionally the appropriate target group to support maintaining and increasing oral health. We aimed to develop and validate personas that reflect the attitudes and needs of MHNs regarding oral health in patients with a psychotic disorder. We used a human-centered design with contextual interviews (n = 10) to address the key issues of the problems and needs of MHNs working with patients with a psychotic disorder. We analyzed the data thematically and reflected on insights into unique personas, which were then validated by conducting semi-structured interviews (n = 19) and member checking. Four personas were found based on attitudes and perspectives, barriers, needs, suggestions for interventions, and site conditions regarding practicing oral care in this patient group. Our findings were as follows: the attitudes and perspectives differed from not feeling any responsibility to a holistic obligation, including oral health; suggestions for interventions for MHNs ranged from interventions focusing on improving skills and knowledge to using practical tools; most MHNs recognized themselves within a persona that had a holistic obligation that included oral health; in addition, the MHNs indicated that they considered the issue of oral health in this patient group important, but, in practice, took little responsibility for that role. These findings suggest that a toolkit with interventions for MHNs that are tailored to the personas that emerged from our research should be developed by MHNs in co-creation with designers. The differences between the perceived role and MHNs’ practice in oral health highlighted the need for role clarification and professional leadership of MHNs regarding oral health, which should be considered when developing interventions.

Accessible summary: What is known on the subject?: Oral health consists of more than having good teeth; it is an important factor in general health and well‐being. Despite its importance, oral health care is still largely overlooked in mental health nursing. There is no research available about oral health risk factors and OHRQoL in patients diagnosed with a psychotic disorder with a psychotic disorder (first‐episode). What does this paper add to existing knowledge?: This study provides insight into the severity of the problem. It demonstrates the differences in risk factors and OHRQoL between patients diagnosed with a psychotic disorder (first‐episode) and the general population. A negative impact on OHRQoL is more prevalent in patients diagnosed with a psychotic disorder (first‐episode) (14.8%) compared to the general population (1.8%). Patients diagnosed with a psychotic disorder (first‐episode) have a considerable increase in odds for low OHRQoL compared to the general population, as demonstrated by the odds ratio of 9.45, which supports the importance of preventive oral health interventions in this group. What are the implications for practice?: The findings highlight the need for oral health interventions in patients diagnosed with a psychotic disorder (first‐episode). Mental health nurses, as one of the main health professionals supporting the health of patients diagnosed with a mental health disorder, can support oral health (e.g. assess oral health in somatic screening, motivate patients, provide oral health education to increase awareness of risk factors, integration of oral healthcare services) all in order to improve the OHRQoL. Introduction: No research is available about the oral health risk factors and oral health‐related quality of life (OHRQoL) in patients diagnosed with a psychotic disorder.Aim: To compare oral health risk factors and OHRQoL in patients diagnosed with a psychotic disorder (first‐episode) to people with no history of psychotic disorder.Method: A case–control comparison (1:2) multivariable linear regression analysis and an estimation of prevalence of impact on OHRQoL.Results: Patients diagnosed with a psychotic disorder (first‐episode) have lower OHRQoL with more associated risk factors. Of the patients diagnosed with a psychotic disorder (first‐episode), 14.8% reported a negative impact on OHRQoL, higher than the prevalence of 1.8% found in people from the general population.Discussion: The high prevalence rate of a negative impact on OHRQoL in patients diagnosed with a psychotic disorder (first‐episode) shows the importance of acting at an early stage to prevent a worse outcome.Implications for practice: The findings highlight the need for oral health interventions in patients diagnosed with a psychotic disorder (first‐episode). Mental health nurses, as one of the main health professionals supporting the health of patients diagnosed with a mental health disorder, can support oral health (e.g. assess oral health in somatic screening) in order to improve the OHRQoL.

Poor oral health affects quality of life and daily functioning in the general population and especially in patients with mental health disorders. Due to the high burden of oral health-related quality of life in patients with a mental health disorder, it is important for nurses to know how they can intervene in an early phase. The aim of this systematic scoping review was to identify and appraise oral health interventions in patients with a mental health disorder. A systematic scoping review with a critical appraisal of the literature was conducted using the Joanna Briggs Institute (JBI) methodology for scoping reviews and their checklists. MEDLINE, CINAHL, PsycINFO and reference lists were searched from their inception until December 2020. Results: Eleven quantitative studies were included in the review: four randomized controlled trials, six quasi-experimental studies and one cohort study. Studies focused on interventions for patients (n = 8) or focused on patients together with their professionals (n = 3). Four types of oral health interventions in mental health were found: (I) educational interventions; (II) physical interventions; (III) interventions combining behavioural and educational elements and (IV) interventions combining educational and physical elements. All studies (n = 11) had an evaluation period ≤12 months. Nine studies showed an effect on the short term (≤12 months) with regard to oral health knowledge, oral health behaviour, or physical oral health outcomes (e.g., plaque index). Two studies showed no effects on any outcome. Overall, the methodological insufficient to good. Conclusion: Four types of interventions with positive effects (≤12 months) on oral health knowledge, oral health behaviour, and physical oral health outcomes in different diagnostic patient groups were found. Due to the heterogeneity in both interventions, diagnostic groups and outcomes, one golden standard oral health intervention cannot be advised yet, although the methodological quality of studies seems sufficient. Developing an integrated oral health toolkit might be of great importance in mental health considering its potential effect on oral health-related quality of life.