Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies

Luz, Priscilla de Oliveira; Souza, Adriana Almeida de; Boska, Gabriella de Andrade; Cardoso, Marilia Mastrocolla de Almeida; Candido, Bruna de Paula; Oliveira, Márcia Aparecida Ferreira de

doi:10.1590/0034-7167-2022-0550

Priscilla de Oliveira Luz Corresponding author: Priscilla de Oliveira Luz E-mail: pris_luz@usp.br

conception or design of the study/research

data analysis and/or interpretation

final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0003-0120-1667

Adriana Almeida de Souza

data analysis and/or interpretation

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0003-2940-4829

Gabriella de Andrade Boska

conception or design of the study/research

data analysis and/or interpretation

final review with critical and intellectual participation in the manuscript

Universidade Estadual Centro-Oeste. Guarapuava, Paraná, Brazil

https://orcid.org/0000-0002-5827-6486

Marilia Mastrocolla de Almeida Cardoso

conception or design of the study/research

data analysis and/or interpretation

final review with critical and intellectual participation in the manuscript

Faculdade de Medicina de Botucatu, Hospital das Clínicas. Botucatu, São Paulo, Brazil

https://orcid.org/0000-0002-6231-5425

Bruna de Paula Candido

final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0003-2822-2484

Márcia Aparecida Ferreira de Oliveira

conception or design of the study/research

data analysis and/or interpretation

final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. São Paulo, São Paulo, Brazil

https://orcid.org/0000-0002-1069-8700

Corresponding author: Priscilla de Oliveira Luz E-mail: pris_luz@usp.br

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Mellina Yamamura

Quote	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10
Baldwin L, 2002(¹⁶16 Baldwin L. The nursing role in out-patient child and adolescent mental health services. J Clin Nurs. 2002;11(4):520-5. https://doi.org/10.1046/j.1365-2702.2002.00600.x https://doi.org/10.1046/j.1365-2702.2002... )	Y	Y	Y	Y	Y	Y	Y	Y	No	Y
Anderson M. et al., 2003(¹⁵15 Anderson M, Standen P, Noon J. Nurses’ and doctors’ perceptions of young people who engage in suicidal behaviour: a contemporary grounded theory analysis. Int J Nurs Stud. 2003;40(6):587-97. https://doi.org/10.1016/s0020-7489(03)00054-3 https://doi.org/10.1016/s0020-7489(03)00... )	Y	Y	Y	Y	Y	U	U	Y	U	Y
Reiss R. et al., 2015(¹⁴14 Reiss R, Gannon K. How do nurses experience working with adolescents with a diagnosis of “personality disorder” or “emerging personality disorder”? J Psychiatr Ment Health Nurs. 2015;22(4):244-50. https://doi.org/10.1111/jpm.12213 https://doi.org/10.1111/jpm.12213... )	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y
Wilson RL, Usher K, 2015(¹⁸18 Wilson RL, Usher K. Rural nurses: a convenient co-location strategy for the rural mental health care of young people. J Clin Nurs. 2015;24(17):2638-48. https://doi.org/10.1111/jocn.12882 https://doi.org/10.1111/jocn.12882... )	Y	Y	Y	Y	Y	U	Y	U	Y	Y
Bertram JE, Sarah CN, McMillen JC, 2013(¹⁷17 Bertram JE, Narendorf SC, McMillen JC. Pioneering the Psychiatric Nurse Role in Foster Care. Arch Psychiatr Nurs. 2013;27(6):285-92. https://doi.org/10.1016/j.apnu.2013.09.003 https://doi.org/10.1016/j.apnu.2013.09.0... )	Y	Y	U	Y	Y	U	No	Y	Y	Y
%	100.0	100.0	80.0	100.0	100.0	40.0	60.0	80.0	60.0	100.0

Study	Data collection and analysis methods	Country	Phenomenon of interest	Context	Population	Description of main results
Baldwin L, 2002(¹⁶16 Baldwin L. The nursing role in out-patient child and adolescent mental health services. J Clin Nurs. 2002;11(4):520-5. https://doi.org/10.1046/j.1365-2702.2002.00600.x https://doi.org/10.1046/j.1365-2702.2002... )	Semi-structured interview collection method/thematic analysis method	United Kingdom	Perception of nurses’ role in child and adolescent mental health teams.	Outpatient mental health service for children and adolescents.	Outpatient mental health service for children and adolescents	While other areas were able to define what was unique to their role, it was found that there was no consensus among nurses about their role due to their training in nursing. There is a risk that, and nurses cannot develop a clearer rationale for their role, or be better able to articulate what they do in these teams, that role may be lost.
Anderson et al. 2003(¹⁵15 Anderson M, Standen P, Noon J. Nurses’ and doctors’ perceptions of young people who engage in suicidal behaviour: a contemporary grounded theory analysis. Int J Nurs Stud. 2003;40(6):587-97. https://doi.org/10.1016/s0020-7489(03)00054-3 https://doi.org/10.1016/s0020-7489(03)00... )	Collection method was semi-structured interview and structured questionnaire/analysis method was the Grounded Theory	United Kingdom	Nursing professionals’ and physicians’ perceptions on suicidal behavior among young people.	Pediatric medicine, accident and emergency services, and psychiatry.	Total 45, with 28 nurses	Two main categories and associated subcategories were identified: Experiences of frustration in practice (subcategories: Non-therapeutic situations; Insubstantiality of interventions and value of life) and relationship strategies with young people (subcategories: Specialized competences in care; Reflections on one’s own experience). The meanings of these categories highlight barriers in the relationship between nurses and physicians that they have with young people who engage in suicidal behavior. If suicide prevention policies around the world are to succeed, the phenomena that impact communication between these professionals and young people need to be addressed in research, education and practice development.
Reiss et al. 2015(¹⁴14 Reiss R, Gannon K. How do nurses experience working with adolescents with a diagnosis of “personality disorder” or “emerging personality disorder”? J Psychiatr Ment Health Nurs. 2015;22(4):244-50. https://doi.org/10.1111/jpm.12213 https://doi.org/10.1111/jpm.12213... )	Semi-structured interview collection method/interpretive phenomenological analysis method	United Kingdom	Nurses’ experience in the specific care for children and young people with personality disorders.	Inpatient unit of mental health services for children and adolescents.	Total 6 nurses	We found two themes. One on the emotional impact of working with these young people and the other on the ways it has affected the clinical team dynamic. Many of the participants’ experiences and desires, such as anger, feeling awkward, and wanting training, are similar to those of nurses working with adults with Parkinson’s disease. Others seem to be more pronounced in this scenario, particularly in relation to the lack of diagnostic certainty, which involves the dilemmas that this brings in the provision of a service, and the difficult interpersonal dynamics in the nurse-patient relationship.
Wilson RL, Usher K,(¹⁸18 Wilson RL, Usher K. Rural nurses: a convenient co-location strategy for the rural mental health care of young people. J Clin Nurs. 2015;24(17):2638-48. https://doi.org/10.1111/jocn.12882 https://doi.org/10.1111/jocn.12882... )	Mixed methods; data collection with in-depth interviews. Data were entered into nVivo10 (QSR International, Doncaster, Australia) and analyzed using thematic techniques.	Australia	Actions that help young people with early mental health issues.	Rural health service.	81 respondents, with 20 nurses	Research findings indicate that providing positive mental health first encounters to rural youth in their communities enables successful initial and ongoing mental health help.
Bertram JE, Sarah CN, McMillen JC, 2013(¹⁷17 Bertram JE, Narendorf SC, McMillen JC. Pioneering the Psychiatric Nurse Role in Foster Care. Arch Psychiatr Nurs. 2013;27(6):285-92. https://doi.org/10.1016/j.apnu.2013.09.003 https://doi.org/10.1016/j.apnu.2013.09.0... )	Qualitative, descriptive study; semi-structured interview script.	United States	Describe the details of psychiatric nurses’ work in a multidisciplinary mental health team and identify gaps.	Care service for children and adolescents with mental health problems.	01 nurse	Psychiatric nurses’ role filled several necessary gaps, as she was able to provide a keen eye for processes and patterns related to psychiatric diagnosis and prescription, help to bolster the confidence of case managers, youth and foster parents to advocate for youth mental health care and provide an integrated perspective on physical and mental health for a population with complex comorbidities.

[1] Corresponding author: Priscilla de Oliveira Luz E-mail: pris_luz@usp.br

Title: Nursing experience in child and adolescent mental health services: a qualitative systematic review
Participants: nursing professionals Phenomenon of interest: experience regarding child and adolescent mental health Context: specialized services in child and adolescent mental health
Summary of findings	Search type	reliability	Credibility	Score ConQual
Nursing care actions in child and adolescent mental health involve understanding the professional role and the need to deal with the emotional repercussions experienced	Qualitative	High*	Moderate^†	Moderate 4(U) + 1(C)

Brasil

Brasil

Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies

Experiencias de enfermería en servicios especializados en salud mental infantil y adolescente: revisión sistemática de estudios cualitativos

ABSTRACT

Objective:

Method:

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Final considerations: