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This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held by nurses of the organisational interfaces, arrangements and provisions of care in these settings.

Data gathered from focus groups held with nurses from two PICUs was used to establish terminology, defining attributes, related concepts, antecedents, values, processes and concepts related to current practices. A literature search was conducted to permit a review of the conceptual arrangements and contemporary understanding of intensive care for people experiencing acute psychiatric illness based on the perspectives held by the nurses from the focus groups.

Dissonance between service needs and the needs and management of individual patients overshadow strategies to implement comprehensive recovery-oriented approaches. Three factors are reported in this paper that influence standards and procedural practice in PICU; organisational structures; physical structures; and subtype nomenclature.

Acute inpatient care is an important part of a comprehensive approach to mental health services. Commonly intensive acute care is delivered in specialised wards or units co-located with acute mental health inpatient units mostly known as PICU. Evidence of the most effective treatment and approaches in intensive care settings that support comprehensive recovery for improved outcomes is nascent.

Current descriptions from nurses substantiate wide variations in the provisions, design and classifications of psychiatric intensive care. Idiosyncratic and localised conceptions of psychiatric intensive care are not adequately entailing effective treatment and methods in support of recovery principles for improved and comprehensive outcomes. The authors suggest that more concrete descriptions, guidelines, training and policies for provision of intensive psychiatric health care encompassing the perspective of nursing professionals, would reinforce conceptual construction and thus optimum treatments within a comprehensive, recovery-oriented approach to mental health services.

A Psychiatric Intensive Care Unit (PICU) and or High Dependency Unit (HDU) is a locked, intensive treatment facility available to people experiencing acute psychiatric distress. For many people who access public mental health services in Australia, the PICU/HDU is the primary point of admission, and should represent and facilitate timely assessment and an optimum treatment plan under a recovery framework. Nurses are the largest health discipline working in this specialty area of care. The paper aims to discuss these issues.

A qualitative study aimed to investigate the skills, experience, and practice, of nurses working in the PICU/HDU in relation to a recovery model of care. Identifying how nurses provide care in the PICU/HDU will inform a clinical practice guideline to further support this specialty area of care. Four focus groups were facilitated with 52 registered nurses attending.

The nurse participants identified specific skills under four distinct themes; Storytelling, Treatment and recovery, Taking responsibility, and Safeguarding. The skills highlight the expertise and clinical standard required to support a recovery model of care in the PICU.

The research findings highlight urgency for a National PICU/HDU clinical practice guideline.

A PICU/HDU practice guideline will promote the standard of nursing care required in the PICU/HDU. The PICU/HDU needs to be recognised as a patient centred, therapeutic opportunity as opposed to a restrictive and custodial clinical area.

Providing transparency of practice in the PICU/HDU and educating nurses to this specialty area of care will improve client outcome and recovery.

Very few studies have explored the skills, experience, and practice, of nurses working in the PICU/HDU in relation to a recovery model of care. A dearth of research exists on what is required to work in this specialty area of care.

The purpose of this research is to report the results of research that was carried out to evaluate the effectiveness of a number of web sites selling chocolate.

The research was founded on a series of criteria for evaluating such web sites, based upon a review of the literature. A series of criteria were developed and a scoring system associated with them was generated. Following a pilot test, a panel of eight volunteers evaluated ten chocolate‐related web sites which were carefully chosen for their range of characteristics.

Aspects evaluated included presentation, content, accessibility, language, navigation and structure, transaction page, security, privacy and authority, and marketing factors. The resulting scores were then analysed. Using two different methods of analysis, it was found that the best web site was www.danschocolates.com, but that there was significant inter‐scorer discrepancy in some of the scores assigned.

Only a small number of sites were evaluated, using a relatively small number of evaluators.

Conclusions are drawn regarding the most important factors that web designers should take into account when developing a site for selling chocolate or similar products. Comments are also made on the need to involve real users when developing criteria for the evaluation of web sites.

The paper provides a possible general methodology for evaluating web sites.

The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit that has since closed, and second, to compare staff and patient perceptions of the new ward with their ideal ward environment. The results obtained from patients indicated that there were differences between perceptions of the new treatment unit and the former treatment unit. The results obtained from patients also indicated that there was a difference between perceptions of the new treatment unit and the ideal ward environment. Results obtained from staff could not be analysed because of a low response rate.

The purpose of this paper is to explore whether the current forensic mental health inpatient population within a medium secure unit is more or less complex (i.e. clinical and risk presentations) than former years using the Health of the Nation Outcome Scale (HoNOS) secure. Additionally, the use of the HoNOS secure as a service-wide measure is discussed in terms of its usefulness. Clinical implications and recommendations are offered for the continued use of the HoNOS secure in services more widely.

A retrospective case review of completed HoNOS secure assessments for 130 patients over three time intervals 2012, 2015 and 2018 was used. A multivariate analysis was performed on the data using SPSS version 25.

The findings revealed that contrary to clinical opinion, inpatients’ clinical and risk presentations had not changed significantly overtime.

The study shows the benefits of using the HoNOS secure at a service-wide level to explore and understand similarities and differences in inpatient admissions over time. It also highlights the usefulness of the HoNOS secure for considering different ward characteristics and the needs of patients residing in these environments.

Although much research exists surrounding the individual use of the HoNOS secure in relation to outcomes, there is limited research focusing on use of the HoNOS secure at the service level. The paper therefore provides evidence of the utility and value of the HoNOS secure as a service-level outcome measure.

The purpose of this paper is to explore service users’ experience of community meetings (CMs) within a high secure setting.

A qualitative design was employed in which focus groups were used to capture service users’ experience of CMs. In all, 12 focus groups comprising a total of 27 participants were carried out using a semi-structured interview schedule. Data were analysed using thematic and saliency analysis, identifying themes which were pertinent to the research aims.

Positive experiences reported by service users included a safe space to explore ward issues and develop skills, with some viewing the meeting as a therapeutic forum in which to facilitate personal growth.

There were a wide range of patient presentations and views. Furthermore, only 20 per cent of the patient population were included within this study.

A number of recommendations have been identified that can have positive implications for patients (quality of life and recovery), staff (resolving conflicts and problem-solving) and the overall therapeutic milieu of the ward.

There are no reviews looking at CMs within the last decade. This paper brings the understanding up to date to allow the development of this potentially positive tool.

In the year 2000, the UK government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible and advocated the introduction of a ward housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward‐based non‐clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. In 2002 the Facilities Management Graduate Centre at Sheffield Hallam University completed a series of six case studies looking at the role within different NHS Trusts. These were developed through interviews and observations with the facilities manager, ward housekeepers and nursing staff and also by collecting documentary evidence such as job descriptions, financial details and training information. Common themes were identified, relating to experiences of developing and implementing the ward housekeeper role. This paper suggests models of best practice relating to role, recruitment, induction, training, integration and management.

Attachment Theory can be regarded as central to the concept of relational security. There is a paucity of research examining the coherence of this construct for ward-based staff. The paper aims to discuss these issues.

Five female nurses from the acute admission and assessment ward of a UK medium secure unit acted as participants. Semi-structured interviews were conducted, and inductive thematic analysis was applied.

Six themes; “staff-service user relationships”, “staff diversities”, “service user backgrounds”, “variability in service users’ presentations”, “service users with personality disorder are problematic” and “nurses do not use attachment” emerged from the data. The nurses used heuristic models of attachment-related behaviour and they lacked knowledge of constructs associated with Attachment Theory.

Acute admissions may not be representative of all treatment contexts. Traditional models of attachment style may have only limited relevance in forensic services.

Limited knowledge and confidence in the nurses regarding how Attachment Theory might apply to service users is interesting because it may limit the extent to which care, treatment and risk management might be informed by an understanding of service user representations of therapeutic relationships. Training and educational interventions for nurses that enhance understanding of personality development and attachment styles are warranted.

The importance of nurses for achieving relational security is emphasised and the adequacy of their training is questioned.

The purpose of this paper is to undertake a systematic literature review to appraise the current evidence relating to the factors associated with violence and aggression in adult psychiatric hospital inpatient settings.

A systematic search of following four databases was conducted: Scopus, PsychINFO Medline, CIHAHL and PsychArticle. Following the application of the inclusion criteria, ten papers were extracted and included in the review. A quality appraisal tool, Mixed Methods Appraisal Tool (MMAT) version 2011 (Pluye et al., 2011), was employed for the appraisal of the qualitative and quantitative studies. MMAT has been designed for systematic literature reviews that include qualitative, quantitative and mixed methods studies. Of these, eight were of quantitative methodology and two were of qualitative studies.

These ten papers provide an insight into factors associated with violence and aggression towards nursing staff. Three main themes were identified: the environment, attitudes/interaction of staff, and the patient’s mental illness. The themes were important factors in the causes of violence but were interlinked highlighting the complex nature of violence towards nursing staff. The findings support the need for training for nursing staff and the development of ongoing support and for organisations to consider both the environment and the restrictive procedures to help reduce violence and aggression towards nursing staff.

The paper concludes by outlining the importance of considering the three main themes for clinical practice, training and development of secure services.

This paper gives insight into the factors associated with patient violence and aggression towards nursing staff in a secure setting.

Since the end of the latest rice-pledging scheme, Thai rice farmers have had more freedom in selecting marketing channels. Understanding the determinants of farmers' decision-making associated with these channels is of particular interest to multiple stakeholders in the rice value chain. This study aims to examine how economic, relational and psychological factors concurrently underpin Thai rice farmers' decision-making and influence their marketing channel choice.

Drawing on the theory of reasoned action and utility maximization of farmers’ decision making, this study used structural equation modeling to examine data collected from a nationwide sample of Thai rice farmers (n = 637), focusing on their past and intentional use of the three major marketing channels for paddy rice.

The determinants identified include four direct independent variables: attitude, subjective norm (social referents), transaction conditions and economic goals, and two indirect independent variables: past behavior and trust. Multi-group analysis suggests that rice co-operative users were more empowered to consider economic goals and attitude toward the channel, whilst rice miller and local collector users were more likely to be influenced by their social referents and the transaction conditions offered by the channel.

The findings highlight the need for policy to address trust and transparency issues with intermediaries and to empower farmers through the improvement of market access.

The study makes a unique and substantive contribution to the knowledge of farmers' decision-making about marketing channel choice in Thailand and theoretically contributes to the indirect role of past behavior in predicting prospective intention.