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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Caracterização clínica e sócio-demográfica da população atendida por um serviço de interconsulta de terapia ocupacional em um hospital geral universitário Clinical characterization and socio-demographic of the population served by a Consultation-Liaison Service Occupational Therapy in a University General Hospital

Maria Gabriela Junqueira Pernambuco Barboza Gomes 28 July 2008 (has links)
A Interconsulta Psiquiátrica é considerada uma área da Psiquiatria, que trabalha no Hospital Geral compondo uma equipe (Psiquiatria de Ligação) ou prestando seus serviços a uma equipe solicitante (Consultoria Psiquiátrica). O Serviço de Interconsulta em Psiquiatria (SIP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) teve início em março de 1978 e a Terapia Ocupacional passou a integrar esta equipe em 1999. O cotidiano hospitalar tem uma marca própria com obrigações como usar vestimentas, ter horários previamente estabelecidos para se alimentar, para cuidar de sua higiene e para receber visitas, inclusive dos familiares. Os terapeutas ocupacionais, como profissionais que lidam com o cotidiano do indivíduo, têm sido inseridos nas equipes multiprofissionais do Hospital Geral, contribuindo com seus conhecimentos teóricos e técnicos específicos para cuidar de pessoas hospitalizadas. Apesar das várias funções que a Terapia Ocupacional (TO) pode exercer no Serviço de Interconsulta, existe escassez de estudos publicados sobre o perfil sócio-demográfico dos pacientes atendidos, o que prejudica o planejamento de ações e o levantamento da necessidade de recursos humanos para aquele Serviço. O objetivo deste trabalho foi realizar um estudo retrospectivo dos Pedidos de Interconsulta (PIs) para a TO do Serviço de Interconsulta em Saúde Mental (SISMen) do HCFMRP - USP no período de janeiro de 2000 a dezembro de 2005. Os sujeitos foram os indivíduos que estiveram internados nas enfermarias do campus do hospital universitário e para quem foi solicitada a assistência do Serviço de TO naquele período, perfazendo um total de 633 pacientes e 709 PIs. Os dados foram coletados mediante consulta dos PIs e dos prontuários dos pacientes. A maioria dos sujeitos consultados foi do sexo feminino, com ensino fundamental incompleto e houve distribuição equilibrada entre os solteiros e casados. Quanto à idade e à situação laboral, a média de idade dos pacientes foi de 39,2 anos e a maioria deles era autônoma ou aposentada, seguida de dona de casa. Verificou-se que a Clínica Médica foi a responsável por mais do que um terço dos Pedidos de Interconsulta feitos para o Serviço de TO, seguida das clínicas Unidade Metabólica e Psiquiatria respectivamente; o tempo médio de internação dos pacientes encaminhados para esse Serviço foi de 51 dias, sendo que a média de internação no HCFMRP-USP foi de 6,4 dias. Consequentemente, o gasto desses pacientes variou entre uma e 2,4 vezes mais do que os pacientes internados nesta instituição. A taxa média de encaminhamento para a TO do SISMen foi de 0,5%, sendo que o motivo de solicitação mais freqüente esteve relacionado aos aspectos emocionais do indivíduo, seguido por fatores referentes à hospitalização. Estes dados, de modo geral, estão de acordo com a literatura nacional e internacional dos SIPs. Concluiu-se que há necessidade de um instrumento padronizado para avaliar a população atendida pelo Serviço de Interconsulta de TO e que alguns pontos merecem estudos mais detalhados como a possibilidade de existência de associações entre dados sócio-demográficos e clínicos e o encaminhamento dos pacientes para esse Serviço. Consultation Liaison Psychiatric is considered to be an area of Psychiatry which is part of a General Hospital, involving a team (Liaison Psychiatry) or providing services to a team that requests them (Psychiatric Consultation). The Consultation Liaison Psychiatric Service (CLPS) of the University Hospital, Faculty of Medicine of Ribeirão Preto (HCFMRPUSP) was started in March 1978 and Occupational Therapy became part of this team in 1999. The daily hospital routine has specific rules such as wearing specific clothing and taking meals, caring for ones hygiene and receiving visits, including those of relatives, at pre-established times. Occupational therapists, as professionals who deal with the daily routine of an individual, have been inserted into the multiprofessional teams of the General Hospital, contributing their specific theoretical and technical knowledge to the care of hospitalized persons. Despite the various functions Occupational Therapy (OT) can perform in the CLPS, there is a scarcity of published studies on the sociodemographic profile of attended patients, impairing the planning of actions and the determination of the human resources needed for that Service. The objective of the present investigation was to conduct a retrospective study of the Requests of Consultation Liaison (RCLs) sent to the OT of the Service of The Consultation Liaison in Mental Health (SCLMH) of HCFMRP-USP during the period from January 2000 to December 2005. The subjects involved were the individuals who had been admitted to the wards of the University Hospital and for whom the assistance of the OT Service had been requested during that period, for a total of 633 patients and 709 RCLs. The data were collected from the RCLs and the medical records of the patients. Most of the subjects involved were women with incomplete elementary schooling, with a balanced distribution of single and married subjects. Mean patient age was 39.2 years and most patients were self-employed or retired, followed by the housewife category. Internal Medicine was responsible for more than one third of the RCLs sent to the OT Service, followed by the Metabolic Unit and Psychiatric clinics. The mean time of hospitalization of the patients referred to this Service was 51 days, with the mean duration of hospitalization at HCFMRPUSP being 6.4 days. Consequently, the expenses with these patients ranged from one to 2.4 times more than those for the patients hospitalized in this institution. The mean rate of referral to the OT of the SCLMH was 0.5%, with the most frequent reason for the request being related to the emotional aspects of the individual, followed by factors related to hospitalization. These data, in general, agree with the Brazilian and international literature about the CLPS. We conclude that there is the need for a standardized instrument for the evaluation of the population attended at the Consultation Liaison Service of OT and that some points need more detailed studies regarding the possibility of the existence of an association between sociodemographic and clinical data and the referral of these patients to the OT Service.
2

Aventuras da Psiquiatria no Hospital Geral: Aspectos históricos da interconsulta na UFPE e no HBL

LUNA, Juliano Victor Albuquerque 12 July 2016 (has links)
Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-09-14T17:09:11Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11130689 bytes, checksum: a577f73fe7d8e20644a19bcc4ba15002 (MD5) Made available in DSpace on 2016-09-14T17:09:11Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11130689 bytes, checksum: a577f73fe7d8e20644a19bcc4ba15002 (MD5) Previous issue date: 2016-07-12 A história da psiquiatria, em sua maior parte, confunde-se com a história dos asilos. Os Hospitais Gerais desenvolveram-se, ao longo da história da medicina, como ambientes em que não havia espaço para os loucos. A partir do século XX, começa a ocorrer uma mudança nesse paradigma, sobretudo nos EUA e na Europa, com a criação das UPHGs em diversos serviços por lá, e a consolidação da Interconsulta psiquiátrica como área de atuação da psiquiatria, que passa a estreitar o contato com o restante da medicina. Foi um movimento que rendeu diversos avanços tanto à psiquiatria quanto às outras áreas médicas. No Brasil, esse percurso começou na década de 1950 e ocorre de forma mais tímida. Apenas 1,1% dos Hospitais gerais contam com suporte da psiquiatria em nosso país atualmente. Contudo, houve espaço no Brasil para o desenvolvimento de projetos pioneiros nesse campo, cuja história não está registrada. A psiquiatria pernambucana foi protagonista na empreitada, inaugurando inclusive a integração da psiquiatria ao hospital geral no Brasil. Pernambuco também foi um dos pioneiros na introdução da clínica psicanalítica em hospitais gerais do serviço público. O presente trabalho pretende registrar a história dessas experiências. Para tanto, escolhemos os serviços da UFPE e do Hospital Barão de Lucena, sedes dos primeiros serviços de saúde mental em hospital geral de Pernambuco. Fez-se uma ampla pesquisa documental, além de serem entrevistados alguns dos principais atores da construção desses serviços. Apesar de difícil, a integração dos cuidados de saúde mental ao hospital geral na UFPE e no HBL conseguiu efetivar-se, a partir da psiquiatria na UFPE e da psicanálise no HBL. Foram espaços configurados e sustentados dentro de uma perspectiva de formação, para além da assistência, e acreditamos que sua longevidade tenha relação com isso. The history of psychiatry, for the most part, is intertwined with the history of asylums. General Hospitals have developed mostly as environments in which there was no room for the insane. Since the early twentieth century, a paradigm shift takes place, specially in the US and Europe, with the creation of psychiatryc units in several General Hospitals there. It led to the consolidation of Consultation Liaison Psychiatry as an official sub-specialty of Psychiatry. Integration of Psychiatry and other medical specialties was a movement that yielded many advances in both psychiatry as other medical areas. In Brazil, this journey began in the 1950s and is more . Only 1.1% of brazilian general hospitals have psychiatric support nowadays. However, there was room in Brazil for the development of pioneering experiments in this field, whose history is not recorded. Pernambuco’s psychiatry had a key role in these experiments, inaugurating the integration of psychiatry to the general hospital in Brazil. Pernambuco was also one of the first places to have a psychoanalytic couch in public service facilities. This work aims to record the history of these pioneering experiences in the state of Pernambuco. Therefore, we chose the services of UFPE and the Hospital Barão de Lucena, headquarters of general Hospital Psychiatry in Pernambuco. An extensive literature research was done, along with statements collection from some of the major players in the construction of these services. Although difficult, the integration of mental health care to the general hospital at UFPE and HBL was sucessful, arising from psychiatry at UFPE and psychoanalysis at in HBL. They were configured spaces and sustained in a training perspective, and we believe that it explains their longevity.
3

Aventuras da psiquiatria no Hospital Geral: aspectos históricos da interconsulta na UFPE e no Hospital Barão de Lucena

LUNA, Juliano Victor Albuquerque 12 July 2016 (has links)
Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-05-12T19:01:29Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11109168 bytes, checksum: 1032a08c27aa11c40a06a7024ebe6551 (MD5) Made available in DSpace on 2017-05-12T19:01:29Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11109168 bytes, checksum: 1032a08c27aa11c40a06a7024ebe6551 (MD5) Previous issue date: 2016-07-12 A história da psiquiatria, em sua maior parte, confunde-se com a história dos asilos. Os Hospitais Gerais desenvolveram-se, ao longo da história da medicina, como ambientes em que não havia espaço para os loucos. A partir do século XX, começa a ocorrer uma mudança nesse paradigma, sobretudo nos EUA e na Europa, com a criação das UPHGs em diversos serviços por lá, e a consolidação da Interconsulta psiquiátrica como área de atuação da psiquiatria, que passa a estreitar o contato com o restante da medicina. Foi um movimento que rendeu diversos avanços tanto à psiquiatria quanto às outras áreas médicas. No Brasil, esse percurso começou na década de 1950 e ocorre de forma mais tímida. Apenas 1,1% dos Hospitais gerais contam com suporte da psiquiatria em nosso país atualmente. Contudo, houve espaço no Brasil para o desenvolvimento de projetos pioneiros nesse campo, cuja história não está registrada. A psiquiatria pernambucana foi protagonista na empreitada, inaugurando inclusive a integração da psiquiatria ao hospital geral no Brasil. Pernambuco também foi um dos pioneiros na introdução da clínica psicanalítica em hospitais gerais do serviço público. O presente trabalho pretende registrar a história dessas experiências. Para tanto, escolhemos os serviços da UFPE e do Hospital Barão de Lucena, sedes dos primeiros serviços de saúde mental em hospital geral de Pernambuco. Fez-se uma ampla pesquisa documental, além de serem entrevistados alguns dos principais atores da construção desses serviços. Apesar de difícil, a integração dos cuidados de saúde mental ao hospital geral na UFPE e no HBL conseguiu efetivar-se, a partir da psiquiatria na UFPE e da psicanálise no HBL. Foram espaços configurados e sustentados dentro de uma perspectiva de formação, para além da assistência, e acreditamos que sua longevidade tenha relação com isso. The history of psychiatry, for the most part, is intertwined with the history of asylums. General Hospitals have developed mostly as environments in which there was no room for the insane. Since the early twentieth century, a paradigm shift takes place, specially in the US and Europe, with the creation of psychiatryc units in several General Hospitals there. It led to the consolidation of Consultation Liaison Psychiatry as an official sub-specialty of Psychiatry. Integration of Psychiatry and other medical specialties was a movement that yielded many advances in both psychiatry as other medical areas. In Brazil, this journey began in the 1950s and is more . Only 1.1% of brazilian general hospitals have psychiatric support nowadays. However, there was room in Brazil for the development of pioneering experiments in this field, whose history is not recorded. Pernambuco’s psychiatry had a key role in these experiments, inaugurating the integration of psychiatry to the general hospital in Brazil. Pernambuco was also one of the first places to have a psychoanalytic couch in public service facilities. This work aims to record the history of these pioneering experiences in the state of Pernambuco. Therefore, we chose the services of UFPE and the Hospital Barão de Lucena, headquarters of general Hospital Psychiatry in Pernambuco. An extensive literature research was done, along with statements collection from some of the major players in the construction of these services. Although difficult, the integration of mental health care to the general hospital at UFPE and HBL was sucessful, arising from psychiatry at UFPE and psychoanalysis at in HBL. They were configured spaces and sustained in a training perspective, and we believe that it explains their longevity.
4

Caracterização do padrão de solicitações psiquiátricas em um hospital geral: estabilidade e mudanças em um período de 30 anos de um serviço de Interconsulta Referral pattern of requests in a general hospital: stability and change over a period of 30 years of consultation-liaison service

Tatiana Iuriko Kawasaki Nakabayashi 17 October 2012 (has links)
A Interconsulta Psiquiátrica é considerada por muitos pesquisadores como sendo a área prática e aplicada da Medicina Psicossomática, de conhecimento concernente à investigação da interação entre fatores biológicos e psicossociais no desenvolvi-mento, curso e resultado de todas as doenças. A prevalência de transtornos psiqui-átricos em hospitais gerais pode variar de 20 a 40% entre pacientes internados, po-rém uma reduzida parcela é assistida pela Interconsulta e consequentemente recebe tratamento psiquiátrico. Sendo assim, o presente estudo teve por objetivos: a) obter informações dos dados sociodemográficos dos pacientes e seus históricos em sa¬úde mental (tratamentos anteriores e tentativa de suicídio); b) analisar o uso do ser¬viço de Interconsulta Psiquiátrica, tais como as clínicas solicitantes, função dos pro¬fissionais solicitantes, motivos de solicitação, tempo de internação dos pacientes assistidos, tempo de solicitação do PI e de sua resposta, e o número de atendimen-tos realizados; c) descrever os diagnósticos clínicos e psiquiátricos dos pacientes avaliados através dos critérios estabelecidos pela CID-10; d) analisar intervenções farmacoterapêuticas e não medicamentosas, tais como as condutas sugeridas pelo interconsultor, profissionais solicitados durante a internação, as medicações psico-trópicas em uso e prescritas; e) caracterizar aspectos relacionados aos médicos clí-nicos, aos profissionais de saúde e aos interconsultores; e f) avaliar a qualidade es-trutural da solicitação psiquiátrica realizada pelo profissional clínico e a resposta dada pelo interconsultor. Para tanto, foi realizada uma análise retrospectiva de todas as solicitações consecutivas realizadas entre janeiro de 1981 a dezembro de 2010 para a Psiquiatria do Serviço de Interconsulta em Saúde Mental do Hospital das Clí-nicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo assim como a consulta dos prontuários de todos os pacientes assistidos pelo serviço para obter outras informações. Foram realizadas 4882 solicitações psiquiátricas e a taxa de encaminhamento variou de 0,7 a 1,1%. Dados sociodemográficos dos paci-entes que foram atendidos com mais fre¬quência relacionados ao sexo, cor e/ou et-nia, estado civil, com quem os pacientes residiam (somente para os homens), situa-ção laboral (somente para as mulheres), escolaridade e procedência tenderam a permanecer relativamente estáveis ao longo dos anos. As mulheres apresentaram idade média menor que os homens e foram atendidos com mais frequência: homens e mulheres casados (e mais homens soltei¬ros quando comparados com as mulhe¬res), homens que residiam com seus pais e mulheres que residiam com seus cônju¬ges e filhos, homens afastados de seus tra¬balhos e mulheres responsáveis pelos cuidados da casa, e também pacientes de ambos os sexos com idades entre 21 e 50 anos, pacientes caucasianos, pacientes procedentes do estado de São Paulo e pacientes com escolaridade até ensino fun¬damental completo. As mulheres foram mais frequentemente assistidas pelo serviço de Intercon¬sulta Psiquiátrica ao longo de todos os anos, assim como ficaram menos tempo in¬ternadas e também tiveram solicitações psiquiátricas realizadas em um menor inter¬valo de tempo após a admis¬são hospitalar. Em trinta anos, a Clínica Médica Geral foi a clínica que mais realizou solicitações psiquiátricas, o motivo de solicitação mais frequente foi a presença de sintomas psiquiátricos e o tempo de internação dos pacientes assistidos pela Inter¬consulta foi maior quando comparado aos pacientes internados no hospital de modo geral. Os transtornos neuróticos, somatoformes e relacionados ao estresse foram os diagnósticos psiquiátricos mais comuns entre as mulheres e homens atendidos pelo SISMen, seguido pelos transtornos de humor e transtornos mentais orgânicos nas mulheres e transtornos mentais orgânicos e transtornos devido ao uso de substân¬cias nos homens. Já em relação ao diagnóstico clínico, foram atendidos com mais frequência mulheres com doenças endócrinas, metabólicas e nutricionais e homens com doenças infecciosas e parasitárias; e casos de múltiplas comorbidades clínicas se tornaram mais frequentes com o passar dos anos. As principais condutas sugeri¬das pelos interconsultores foram: atendimento individual, orientação à equipe e prescrição de psicofármacos para ambos os pacientes, permanecendo frequentes ao longo dos anos, com destaque para um aumento progressivo de casos em que medicações psicotrópicas foram prescritas a partir de meados dos anos 90. E com o passar dos anos, os planos de tratamento se tornaram mais complexos e abran¬gentes e houve um aumento progressivo no número de encaminhamentos para atendimento psiquiátrico ambulatorial. Em relação à qualidade estrutural das solici¬tações psiquiátricas e das respostas dadas pelos interconsultores, ambas foram consideradas aceitáveis ou boas na maioria dos casos, sendo um indicativo positivo na qualidade de comunicação entre os profissionais. Pode-se dizer que este foi o primeiro estudo longitudinal a analisar consecutivamente trinta anos e também toda a população assistida por um serviço de Interconsulta Psiquiátrica Consultation-liaison Psychiatry is considered by many researchers as the practical and applied area of psychosomatic medicine, which is an area of knowledge concerning the investigation of the interaction between biological and psychosocial factors in the development, course and outcome of all diseases. The prevalence of psychiatric disorders in general hospitals range from 20 to 40% of hospitalized patients, but a small portion is assisted by the consultation-liaison and consequently receives psychiatric treatment. Considering this background, this study aimed: a) to obtain information about sociodemographic characteristics of patients and their mental health history (previous treatment and attempted suicide); b) to analyze the referral patterns of consultation-liaison psychiatry, such as referral sources, reasons for referral, length of stay, lagtime and other; c) to describe clinical and psychiatric diagnoses according by ICD-10; d) to analyze pharmacotherapeutic and non-drug interventions; e) to describe aspects related to physicians, health professionals and psychiatrists; and f) to analyze the structural quality of the request made by the physicians and psychiatrists. For this purpose, it was performed a retrospective analysis of all consecutive referrals made between January 1981 and December 2010 to consultation-liaison psychiatry of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo as well as the review of medical charts of all patients assisted by the service. 4882 referrals were made and consultation rate ranged from 0.7 to 1.1%. Sociodemographic characteristics related to sex, color or ethnicity, marital status, patients who lived (for men), employment status (for women), education and origin tended to remain relatively stable over the years. Women had a lower average age than men and were seen more frequently: married men and women (and more single men compared with women), men who lived with their parents and women who lived with their spouses and children, and also patients of both sexes aged between 21 and 50 years, caucasian patients and patients from the state of Sao Paulo. Women were more often assisted by the consultation-liaison service over the years and the length of stay and lagtime were lower than men. In thirty years, internal medicine was the most frequent referral source, presence of psychiatric symptoms was the common reason for referral and the length of stay of patients assisted by consultation-liaison psychiatry was higher compared to those admitted to the hospital in general. The main clinical diagnoses for women and men were endocrine, nutritional and metabolic, cardiovascular diseases and infectious and parasitic diseases and cases with multiple morbidities have become more frequent over the years. One third of patients were diagnosed with neurotic disorders, stress related and somatoform disorders in women and men, followed by mood disorders and organic mental disorders in women, and organic mental disorders and due to substance use in men. The main interventions were individual therapy, guidelines for staff and prescription of psychotropic drugs for women and men. There was a increase in the number of referrals to outpatient psychiatric care. Psychiatric referrals and responses by psychiatrist were considered acceptable or good in most cases, a positive indicative on the quality of communication between professionals. This was the first longitudinal study to examine thirty years consecutively and also the entire population assisted by Consultation-liaison Psychiatry.
5

A study of the livid world of the patient with borderline personality disorder in New Zealand

Dor, Marlene 2015 (has links)
Borderline Personality Disorder (BPD) is a major health problem and is associated with considerable psychosocial distress and impairment, resulting in a high degree of morbidity and a significant impact on the mental health system. Patients with BPD are difficult to treat clinically, the main issue being engaging the patient and then maintaining the relationship. Patients with BPD constitute 10-20% of psychiatric inpatients, utilise a large amount of mental health resources and have a 10% successful suicide rate. Therefore, it is essential that attention is given to improving effectiveness of treatment approaches for patients with BPD, including engagement. The purpose of the study was to explore and describe the lived world of patients with BPD in order to develop supporting guidelines to improve non-compliance of patients with BPD. The objective of the study was to develop guidelines to improve compliance, which is expected to minimise self-harm risks and improve the quality of the patients’ lives. A qualitative, phenomenological methodology was chosen because it is particularly well suited to study human experiences of health (LoBiondo-Wood & Haber, 2011:141). It is a design that emphasizes discovery through interpreting meaning as opposed to quantification and prediction. Understanding and interpretation of data was thus the hallmark of the research design. This phenomenological study examined human experiences through the descriptions provided by the people involved, i.e. lived experiences. Data collection was done using recorded interviews guided by a semi-structured interview schedule. Memos collected during interviews supplemented the data. Data analysis was hallmarked by constant comparison, contextualisation and description of emerging themes. The main findings, described in three main themes, were the importance of the relationship with the clinician, the overwhelming feelings experienced by the patients and the sense of futility in treatment. These were all linked to the lack of hope the patient felt regarding their clinician, ever being able to manage their continuously oscillating emotions and the purpose of treatment. The findings led to the construction of guidelines to foster initial and continued engagement in treatment with patients with BPD. The guidelines covered issues of clinical practice and management input. Health Studies D. Litt. et Phil. (Health Studies)
6

A study of the livid world of the patient with borderline personality disorder in New Zealand

Dor, Marlene 2015 (has links)
Borderline Personality Disorder (BPD) is a major health problem and is associated with considerable psychosocial distress and impairment, resulting in a high degree of morbidity and a significant impact on the mental health system. Patients with BPD are difficult to treat clinically, the main issue being engaging the patient and then maintaining the relationship. Patients with BPD constitute 10-20% of psychiatric inpatients, utilise a large amount of mental health resources and have a 10% successful suicide rate. Therefore, it is essential that attention is given to improving effectiveness of treatment approaches for patients with BPD, including engagement. The purpose of the study was to explore and describe the lived world of patients with BPD in order to develop supporting guidelines to improve non-compliance of patients with BPD. The objective of the study was to develop guidelines to improve compliance, which is expected to minimise self-harm risks and improve the quality of the patients’ lives. A qualitative, phenomenological methodology was chosen because it is particularly well suited to study human experiences of health (LoBiondo-Wood & Haber, 2011:141). It is a design that emphasizes discovery through interpreting meaning as opposed to quantification and prediction. Understanding and interpretation of data was thus the hallmark of the research design. This phenomenological study examined human experiences through the descriptions provided by the people involved, i.e. lived experiences. Data collection was done using recorded interviews guided by a semi-structured interview schedule. Memos collected during interviews supplemented the data. Data analysis was hallmarked by constant comparison, contextualisation and description of emerging themes. The main findings, described in three main themes, were the importance of the relationship with the clinician, the overwhelming feelings experienced by the patients and the sense of futility in treatment. These were all linked to the lack of hope the patient felt regarding their clinician, ever being able to manage their continuously oscillating emotions and the purpose of treatment. The findings led to the construction of guidelines to foster initial and continued engagement in treatment with patients with BPD. The guidelines covered issues of clinical practice and management input. Health Studies D. Litt. et Phil. (Health Studies)

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