A review of the research literature concerning the role of the social network in health and illness has indicated little attention to studying the social networks of psychiatric patients. Even less attention has been given to the study of veteran psychiatric patients. In an effort to understand more about the supportive or non-supportive aspects of social networks, an exploratory study of 224 male veteran psychiatric patients was conducted in two settings--a general hospital and a large psychiatric hospital. A description of the social networks as perceived by the patients themselves was obtained through semi-structured interviews. Network analysis was used to examine the characteristics of veteran psychiatric patients' personal networks within the social context of needing assistance or support for psychosocial problems. Some aspects of network structure, such as size and availability of family-kin members, were addressed, as well as the nature and quality of network links. Findings indicated that patients had an ample number of family-kin sources to turn to for assistance but chose to turn to only a small number (three or less) of informal sources, including nuclear family, kin, or friends. Formal sources of support were found to play a predominate part in the networks of veteran psychiatric patients. Both the immediate family and institutions were considered to be important sources of help in times of need but a great deal of ambivalence was evident concerning the use of them. A factor analysis of the data identified five social network patterns. Three multiplex patterns emerged in which patients were likely to turn primarily to the nuclear family, to kin, or to significant others for support. Two other patterns were identified--an Anomie Pattern and a Self Versus Institution Pattern--in which neither informal nor formal sources were considered by patients to be sources of support. A stepwise regression was also performed to determine the relationship of selected background variables to choice of support pattern. The variables found to be potentially important predictors of the patterns were marital status, living situation, diagnosis, religious preference, religious practice, age, and history of previous treatment. Conclusions of the study have both clinical and theoretical importance. Findings point to the need for not only reviving or expanding the supportive functions of veteran psychiatric patients' networks, but in some instances the necessity of assisting patients in establishing new personal networks.

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Ward environment as assessed by the Ward Atmosphere Scale was the focus of this exploratory study. The Ward Atmosphere scores of 110 patients hospitalized on two units for acute psychiatric care in a state hospital were analyzed for determining differences along the dimensions of population factors, sex and program change. Significant differences in attitude were obtained on certain of the ten scales for each of the three comparisons. The premise of ward atmosphere being a global entity as implied in the literature was not upheld in this population. Sex differences were noted and introduction of an individualized patient management program evoked significant changes in opinions concerning ward atmosphere. A number of interpretations for these results were offered and implication for future research was suggested.

Cette étude s’appuie sur une recherche ethnographique commencée en octobre 2006, dans le cadre d’un doctorat en anthropologie. C’est une étude qui vise à comprendre la façon dont les relations sociales, qui articulent le continuum accueil-soins des malades, contribuent ou non à l’accès aux soins à l’hôpital Sendwe.<p><p>La plupart des études qui ont abordé la problématique de l’accès aux soins, et de l’utilisation des services de soins dans les hôpitaux publics des pays en développement, ont envisagé cette problématique davantage en termes de carence en matériel ;et réduit souvent l’essentiel des problèmes à une question financière.<p><p>Et pourtant, comme le témoignent des études récentes conduites dans les hôpitaux africains au cours de la dernière décennie, soutenues notamment par une méthodologie qualitative, alliant observations intensives et entretiens approfondis (cf. Jawkes & al. 1998 ;Gobbers, 2002 ;Jaffré & Olivier de Sardan, 2003 ;Vidal & al. 2005 ;Jaffré & al. 2009), l’accès ou non aux soins et l’utilisation des services hospitaliers recouvrent des champs plus vastes et plus complexes qui englobent à la fois des questions, bien sûr, économiques que des problèmes comportementaux d’exclusion, des violences, des humiliations… bref, des questions liées à la relation inégalitaire des pouvoirs due à la distance sociale qui s’observe entre soignant et soigné. Dans le cadre de l’hôpital Sendwe, cette inégalité de la relation soignant-soigné est particulièrement exacerbée par un contexte de misère sociale à laquelle se conjugue une bureaucratisation des tâches dont l’exécution vient ici redoubler au statut du fonctionnaire un pouvoir de soigner. C’est face à cette tension permanente entre partie en interaction favorisée par le décalage entre l’offre médicale et la demande des soins que je me suis interrogé comment les soins hospitaliers sont-ils négociés à l’hôpital Sendwe. Avec quelles ressources les parties s’engagent dans le processus d’accès aux soins ?Quelles sont les pratiques effectives qui s’observent dans les interactions avec le patient et ses proches ?Comment les patients catégorisent-ils le personnel médical, et vice-versa ?Quelles sont les règles, pratiques et morales, qui régissent leurs interactions ?C’est donc à toutes ces questions que cette étude tente de répondre. / Doctorat en Sciences politiques et sociales / info:eu-repo/semantics/nonPublished

Indiana University-Purdue University Indianapolis (IUPUI) / Evidence based practice (EBP) is essential to the practice of nursing for purposes of promoting optimal patient outcomes. Research suggests that the implementation of EBP by staff nurses is problematic and influenced by beliefs, nursing leadership and the work environment. The purpose of this descriptive study was to examine variables that describe the relationship among beliefs about EBP, the work environment and nursing leadership on the EBP implementation activities of the staff nurse. The variables of interest were 1) individual staff nurse characteristics, 2) beliefs about EBP, 3) the EBP work environment and 4) nursing leadership for EBP. A descriptive, quantitative method was used. A sample of 422 Registered Nurses from two urban hospitals (one Magnet and one non-Magnet) completed an online 58 item survey that included questions related to individual belief’s about EBP, the EBP work environment and nursing leadership for EBP as well as EBP implementation activities. Education, tenure and Magnet status were not significantly related to EBP implementation activities in either the univariate or multivariate analysis. EBP beliefs had a significantly positive relationship with EBP implementation activities in both the univariate and multivariate analyses. Work environment and nursing leadership support for EBP had significant positive relationships with self-reported implementation activities in only the univariate analysis. The most surprising finding was that there were no differences between Magnet and non-Magnet work environments for EBP implementation scores, yet the Magnet hospitals reported higher means on the EBP Beliefs Scale than the non-Magnet hospital. The results of this have implications for identifying and testing strategies to influence EBP implementation activities through development of nursing leadership skills for EBP and creating a more EBP friendly work environment.