Art Making as a Health Intervention: Concept Analysis and Implications for Nursing Interventions.

BackgroundCompelling evidence supports the cost effectiveness and potential impact of physical activity on chronic disease prevention and health promotion. Quality of evidence is one piece, but certainly not the sole determinant of whether public health interventions, physical activity focused or otherwise, achieve their full potential for impact. Health promotion at both population and community levels must progress beyond health intervention models that isolate individuals from social, environmental, and political systems of influence.We offer a critical evaluation of lessons learned from two successful research initiatives to provide insights as to how health promotion research contributes to sustained impact. We highlight factors key to success including the theoretical and methodological integration of: i) a social ecological approach; ii) participatory action research (PAR) methods; and iii) an interdisciplinary team.MethodsTo identify and illustrate the key elements of our success we layered an evaluation of steps taken atop a review of relevant literature.ResultsIn the school-based case study (Action Schools! BC), the success of our approach included early and sustained engagement with a broad cross-section of stakeholders, establishing partnerships across sectors and at different levels of government, and team members across multiple disciplines. In the neighbourhood built environment case study, the three domains guided our approach through study design and team development, and the integration of older adults’ perspectives into greenway design plans. In each case study we describe how elements of the domains serve as a guide for our work.ConclusionTo sustain and maximize the impact of community-based public health interventions we propose the integration of elements from three domains of research that acknowledge the interplay between social, environmental and poilitical systems of influence. We emphasize that a number of key factors determine whether evidence from public health interventions in school and built environment settings is applied in practice and policy sectors. These include relationship building at individual, community, and societal levels of the social ecological model, using participatory action research methods, and involving an engaged and committed interdisciplinary team.

Trichotillomania (TTM) is a common psychiatric disorder characterized by a recurrent, irresistible urge to pull out one's hair. This disorder has widespread adverse physical, psychological, social, and emotional effects on the lives of those affected, yet these experiences are under-documented. This study aimed to explore the lived experiences of individuals with TTM in Iran. In this phenomenological study, 12 individuals with TTM (with a mean age of 26.1 ± 6.3 and consisting of seven women and five men) were selected using purposive sampling. Data were collected through in-depth semi-structured interviews and analyzed using Colaizzi's seven-step method. Lincoln and Guba's (2004) criteria were used to ensure trustworthiness, and data management was performed using MAXQDA 2020 software. The experiences of individuals with TTM were categorized into six main themes and 23 sub-themes. The main themes included The Compulsion Loop - Trapped in Repetitive Urges, Emotional Struggles, Identity and Socio-Cultural Pressures, The Body as Battlefield - Physical and Psychological Consequences, Journey Towards Recovery and Barriers to the path of recovery. Individuals with TTM experience intense internal conflict with wide-ranging psychological and social consequences. They are trapped in this destructive behavior due to the immediate gratification derived from hair pulling and tend to conceal the disorder due to social stigma. While some individuals improve through self-regulation and coping strategies such as cognitive behavioral therapy and habit reversal training, others become trapped in a cycle of failure through self-sabotaging defense mechanisms. Increased public awareness, psychosocial support, and the provision of effective therapeutic interventions, such as cognitive behavioral therapy and habit reversal training, are recommended to facilitate the recovery process for these individuals.

More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.

The retail sector is a dynamic and challenging component of contemporary food systems with an important influence on population health and nutrition. Global consensus is clear that policy and environmental changes in retail food environments are essential to promote healthier diets and reduce the burden of obesity and non-communicable diseases. In this article, we explore entrepreneurialism as a form of social change-making within retail food environments, focusing on small food businesses. Small businesses face structural barriers within food systems. However, conceptual work in multiple disciplines and evidence from promising health interventions tested in small stores suggest that these retail places may have a dual role in health promotion: settings to strengthen regional economies and social networks, and consumer environments to support healthier diets. We will discuss empirical examples of health-promoting entrepreneurialism based on two sets of in-depth interviews we conducted with public health intervention actors in Toronto, Canada, and food entrepreneurs and city-region policy actors in St. John's, Canada. We will explore the practices of entrepreneurialism in the retail food environment and examine the implications for population health interventions. We contend that entrepreneurialism is important to understand on its own and also as a dimension of population health intervention context. A growing social scientific literature offers a multifaceted lens through which we might consider entrepreneurialism not only as a set of personal characteristics but also as a practice in networked and intersectoral cooperation for public and population health.

BackgroundWorkplace violence (WPV) represents a major threat to nurses’ health and safety, leading to significant psychological and physical consequences. Despite widespread documentation of its prevalence, evidence on the specific outcomes affecting registered nurses (RNs) remains fragmented and has not been systematically synthesized. The findings of this review extend the current understanding of WPV by demonstrating its cumulative effects on individual RNs, workplace dynamics, and the sustainability of healthcare organizations. They also reveal critical gaps in the literature, particularly regarding longitudinal data, intervention strategies, and the evaluation of organizational policies. These insights provide the foundation for a detailed discussion of the implications of WPV for nursing practices, workforce stability, and health system resilience.AimThe aim of this scoping review was to identify and map the available evidence on the psychological and physical consequences of WPV among RNs, with particular attention to short- and long-term outcomes and differences across clinical and cultural contexts.MethodThis scoping review was conducted following the PRISMA-ScR and JBI guidelines. Studies in English, published between January 2020 and March 2025, with quantitative, qualitative, and mixed-methods designs were included. Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and Scopus, complemented by gray literature sources (Google Scholar, ProQuest Dissertations & Theses) and stakeholder consultation. The search strategy, developed with the support of librarians and healthcare experts, combined controlled vocabulary and keywords and was adapted to each database via the SR Accelerator, which is based on the PCC framework (population, concept, context). Source selection, data extraction, and data synthesis followed the JBI approach.ResultsA total of 5,598 relevant articles were identified, 15 of which met the inclusion criteria. Psychological violence was the most frequently reported form, with outcomes including anxiety, fear, posttraumatic stress, depression, reduced resilience, and cognitive impairments. The physical consequences included sleep disturbances, chronic fatigue, and musculoskeletal pain. Workplace violence emerged as a significant determinant of job satisfaction and turnover intention, with lower job satisfaction mediating up to 44% of the effect of violence on nurses’ intention to leave. Exposure to WPV also contributes to burnout, emotional exhaustion, and feelings of insecurity, highlighting gaps in organizational support and preventive strategies. Important knowledge gaps remain regarding long-term outcomes and cross-context comparisons.ConclusionWPV compromises not only nurses’ psychological and physical well-being but also their organizational climate, quality of care, and patient safety. The lack of adequate postincident institutional support and the underestimation of the problem further exacerbate its impact. Integrated strategies for prevention, monitoring, and management are urgently required, including standardized protocols, targeted training, and accessible psychological support systems. At the same time, further research is needed to explore long-term physical and psychological outcomes and to evaluate the effectiveness of institutional interventions aimed at sustaining resilience and safeguarding patient safety.

Background: Child and adolescent mental health challenges are increasing globally, thereby driving greater demand for inpatient child and adolescent mental health services (CAMHS), where restrictive practices persist despite WHO ambitions to eliminate them. Art therapy is a valuable clinical intervention associated with a significant reduction in these practices. However, there is a gap in knowledge as to why. Aims: This research aimed to hear directly from young people in inpatient CAMHS settings about their experiences of art therapy, and to identify how those findings might help explain the association between art therapy and a reduction in restrictive practices. Methods: Semi-structured, arts-informed interviews using the principles of sensitive enquiry were conducted with twelve young people within two Australian acute inpatient CAMHS units. Transcripts were analysed using reflexive thematic analysis. Results: The inpatient setting gave rise to several challenges, including difficulties communicating with staff, the constraining inpatient environment, and mental health escalations. Art therapy helped reduce acute distress through providing opportunities for freedom, choice and agency, externalising internal states, and generating positive physiological and emotional effects. Conclusions: Art therapy supports young people to navigate acute mental distress by providing an immersive, non-verbal avenue of creative expression within an inpatient CAMHS setting, where there are challenges engaging with verbal therapies. Lowering acute distress through art therapy also helps to circumvent mental health escalations, thereby reducing the likelihood of restrictive practices being used. Implications for practice/policy: The accessibility of art therapy programmes run by qualified art therapists should be a priority in all CAMHS settings.

The purpose of this paper is to examine the concept of nurse-to-nurse lateral violence (LV). Published literature--LV among nurses is significant and results in social, psychological, and physical consequences, negative patient and nursing outcomes, and damaged relationships. An extensive review of literature through Health Source, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest health, and Medical Complete was used to determine agreement and disagreement across disciplines and emerging trends. This concept analysis demonstrates that nurse-to-nurse LV is nurse-to-nurse aggression with overtly or covertly directing dissatisfaction toward another. Origins include role issues, oppression, strict hierarchy, disenfranchising work practices, low self-esteem, powerlessness perception, anger, and circuits of power. The result of this analysis provides guidance for further conceptual and empirical research as well as for clinical practice. Organizations must learn how to eliminate antecedents and provide nurses with skills and techniques to eradicate LV to improve the nursing work environment, patient care outcomes, and nurse retention.

<p style="text-align: justify;">The exploratory study is grounded in field research, utilizing semi-structured interviews with active, former, and recreational athletes in combat sports. The first section outlines key theoretical frameworks that address everyday life, lifestyles, and the issue of doping. The second section presents the main findings from the field research. Interviewees detailed the positive effects of doping on athletic performance while also acknowledging significant side effects, including physical and psychological consequences. Participants highlighted that the availability of information on doping has increased with the advent of the Internet and specialized retail outlets. The testimonies indicate that the culture of doping is driven not only by the pursuit of enhanced sports performance but also by aesthetic considerations and social pressures, underscoring the complexity of doping use in both professional and recreational sports. The study concludes that doping is a pervasive issue in combat sports, necessitating comprehensive social action and collaboration among policymakers, social stakeholders, and researchers across multiple disciplines, with a prominent role for physical education and sports sciences.</p>

ObjectivesTo assess consequences of physical violence at work and identify their predictors.MethodsAmong the patients in a medicolegal consultation from 2007 to 2010, the subsample of workplace violence victims (n = 185) was identified and contacted again in average 30 months after the assault. Eighty-six victims (47 %) participated. Ordinal logistic regression analyses assessed the effect of 9 potential risk factors on physical, psychological and work consequences summarized in a severity score (0–9).ResultsSeverity score distribution was as follows: 4+: 14 %; 1–3: 42 %; and 0: 44 %. Initial psychological distress resulting from the violence was a strong predictor (p < 0.001) of the severity score both on work and long-term psychological consequences. Gender and age did not reach significant levels in multivariable analyses even though female victims had overall more severe consequences. Unexpectedly, only among workers whose jobs implied high awareness of the risk of violence, first-time violence was associated with long-term psychological and physical consequences (p = 0.004). Among the factors assessed at follow-up, perceived lack of employers’ support or absence of employer was associated with higher values on the severity score. The seven other assessed factors (initial physical injuries; previous experience of violence; preexisting health problems; working alone; internal violence; lack of support from colleagues; and lack of support from family or friends) were not significantly associated with the severity score.ConclusionsBeing a victim of workplace violence can result in long-term consequences on health and employment, their severity increases with the seriousness of initial psychological distress. Support from the employer can help prevent negative outcomes.

The aim of this analysis was to define survivor in the cancer context. Cancer survivor has been used in the cancer lexicon, but may not represent the individuals it defines. This concept analysis was completed according to Walker and Avant's method. PubMed, PsychInfo, CINAHL, JSTOR, Google and medical and public health websites. Thirty sources from multiple disciplines, published between 1987-2013, were analysed for recurrent themes and conceptual meaning. Critical attributes, antecedents and consequences were extrapolated. Model, related and contrary cases were developed based on an amalgamation of clinical observations. Illegitimate, borderline and invented cases were excluded for this reason. Survivor in the cancer context is an individual with a history of malignancy, who has lived through a personalized challenge and has ongoing positive and negative consequences. Not all cancer survivors would identify themselves using the term survivor. This contributes to the paradigm shift of cancer as a chronic disease as it establishes the unique nature of the cancer experience while highlighting the long-term concerns related to this set of diseases. The Theory of Uncertainty in Illness provides a framework to understand the individualized nature of being a cancer survivor. Nursing research and practice should address the personal experiences of cancer survivors while still focusing on general survivorship needs.

Comparing the effect of social media-based drama, music and art therapies on reduction in post-traumatic symptoms among Nigerian refugees of Russia's invasion of Ukraine

Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences. Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear. Challenging behaviour of residents can be enervating for nurses and may lead to stress. Although stress in general is associated with negative outcomes, an overview of stress in this context would be a welcome addition to the field. Concept analysis according to Walker and Avant. Identified antecedents of stress: physical and verbal aggression, conflicts, excessive demands and being unresponsive (residents), age, experience, tenure, nursing level and training (nursing staff). Defining attributes: disturbed homoeostasis and the personal appraisal of the situation. Identified consequences regard health, psychological aspects and behaviour. Intervening in the identified factors may contribute to prevention of stress in nursing staff. Given a lack of strong empirical studies, our analysis is not based on a high level of evidence and needs to be tested. Papers from before 1990 might have been missed. The concept analysis revealed that nursing staff stress in the context of challenging behaviour may result from resident and nursing staff factors. Besides health and psychological consequences, behavioural consequences can enormously impact the well-being of residents. Application in daily care to support teams in influencing resident and nursing staff factors could prevent stress, for instance using behavioural management training or recruiting higher educated nursing staff. Given the increasing complexity of care, creating specialized units with specifically trained staff for different groups of people with dementia may be desirable.

Older adults constitute the majority of intensive care unit (ICU) patients, and are increasing in both absolute and relative numbers. Critical care for elderly people should be tailored to their unique physiology, susceptibilities to complications, social circumstances, values, and goals for their care. Knowledge of the short and long-term outcomes of critical illness should guide therapy and goals of care. With a growing number of elderly ICU survivors, the functional, cognitive, and psychological consequences of critical illness and ICU exposure will become a more prominent problem to address. In this chapter, we will discuss morbidity and mortality of elderly ICU patients, provide an evidence-based bundle for the management of pain, agitation, and delirium that has been developed with the vulnerabilities of older patients in mind (though it is also being applied broadly to younger patients as well), and explore the long-term physical, cognitive, and psychological consequences that ICU survivors face.

Background Veterans experience a transition when they return home from military service and resume life as a civilian citizen. Transition refers to service members’ passage from military life to civilian life, which often involves emotional, physical, and social changes. Aims The purpose of this participatory action research study was to address the treatment needs of transitioning veterans with three overarching goals: 1) to unite and empower veterans to contribute to the design of their own art therapy programme to meet their self-identified needs, 2) to contribute to a foundation of knowledge that will help shape future art therapy practices with veterans, and 3) to promote the advancement of art therapy within other organisations. Methods Through collective inquiry, the research team examined how veterans experience the art therapy programme in relationship to their needs and utilised PAR methods to identify ways to strengthen art therapy effectiveness. Results Participating veterans identified seven basic principles of art therapy that support healthy veteran transition from military to civilian life based on their personal experiences with art therapy and transition. Conclusions Co-research can yield rich knowledge and meaningful change by engaging the expertise of people with lived experience. Including art making as a research activity can provide a range of opportunities for researchers to engage in the creation of new knowledge. Implications for practice and research The implementation of the participatory action research framework described in this paper provides a case study illustration for other practitioner researchers that demonstrates the accessibility and value of co-research. Plain-language summary Veterans experience a transition when they return home from military service and resume life as a civilian citizen, or a resident who is no longer part of the Armed Forces. Veterans who participated as co-researchers in this study identified the term transition and described it as the passage from military to civilian live. They described that military-to-civilian transition often involved social, emotional and physical changes. The study was conducted by a group of researchers that included ten veterans of the United States Armed Forces and 1 art therapist using Participatory Action Research methodology, which brings together researchers and people who are impacted directly by the identified problem. A main goal of the study was to provide veterans an opportunity to provide input in the design of the art therapy programme where they received services. The researchers were also interested in finding new knowledge about how art therapy helps veterans. This new knowledge was meant to be shared in order to encourage more art therapy programming for veterans. The group of researchers worked together to study how they experienced services in the programme. By examining how well these services met their needs, veteran-researchers were able to recommend ways to improve the art therapy programme.

A qualitative study was carried out in south-eastern Costa Rica on the circumstances and consequences of snakebite envenomings. This region has the highest incidence of snakebites and the lowest per capita and per family income in the country. There is a high degree of destitution and an unstable labor situation in the region. This study was based on semistructured interviews with 15 people who had suffered snakebite envenomings. This sample size was established on the basis of data saturation. Bites occurred mostly while doing agricultural work, either as salaried workers, as occasional workers, or working on their own. Although all people were attended in health centers of the public health system, and received antivenom free of charge, the majority of them did not receive compensation or rehabilitation upon discharge from the health facilities as a result of not being regular salaried workers. People described many difficulties as a consequence of these envenomings, such as permanent physical sequelae, including two amputations, psychological consequences, economic hardships, and difficulties for reinsertion into agricultural work. In spite of the significant advances that Costa Rica has made for reducing the impact of these envenomings, results reveal issues that require urgent attention by government and civil society organizations, to compensate for the physical, psychological, social, and economic consequences of these envenomings.