Due to the global push for deinstitutionalisation, the care of psychiatric patients has been transferred to their family members. Evidence worldwide however suggests that the rate of deinstitutionalisation has not been matched with the sufficient increase of community resources to support both the caregiver and the patient in the community where they reside (Lippi, 2016:1). The conducted study undertook to explore and describe the experiences of caregivers of Mental Health Care Users (MHCUs) with a diagnosis of Schizophrenia in the southern- western parts of Johannesburg. The goal of the present study was to explore the experiences of the caregivers of MHCUs with schizophrenia in the southern- western parts of Johannesburg. A qualitative research approach was utilised to conduct the study. The researcher made use of purposive sampling and semi-structured, face to face interviews were utilised to collect data. Ten interviews were conducted with caregivers of MHCUs in Lenasia South. The researcher however reports on 9 of the 10 interviews due to the fact that the recording device was stolen in the home of the researcher before the recording could be backed up. The findings of the study indicate that the caregivers of MHCUs often do not know the name of the diagnosis and do not understand the diagnosis. Many of the caregivers held the belief that the MHCU was bewitched. The social lives, health and finances of caregivers were negatively affected by the task of caregiving. The study found that caregivers are reluctant to leave the MHCU alone or in the care of other people, because they are constantly worried about their well-being. The study found that caregivers were stigmatised together with the MHCU in their communities. Community resources to support the caregiver and provide psychoeducation are non-existent in the experience of these caregivers. The study found that caregivers had minimal to no experience at all of receiving support from a social worker. The study concludes that the experiences of caregivers are difficult because of the lack of understanding of the illness, a lack of support and psycho-education and a lack of community resources that can aid the caregiver. Recommendations in the study include making a referral to be seen by a social worker mandatory for each case, social workers facilitating the start-up of peer support groups for the caregivers and being intentional about psycho-educating caregivers. / Mini Dissertation (MSW)--University of Pretoria, 2019. / Social Work and Criminology / MSW / Unrestricted

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

Thesis (M. Cur.) --University of Limpopo, 2015 / Background: Re-admission is a common problem encountered in psychiatric care. Re-admissions are often, but not always, related to a problem inadequately resolved in the prior hospitalization. A better understanding of factors leading multiple psychiatric admissions is needed. Such knowledge can help planners to set priorities and to make appropriate services and resources available to mental health care users and their families after hospital discharge. Objective: The purpose of this study was to explore the factors leading to re-admission of mental health care users at the Thabamoopo Psychiatric Hospital, Limpopo Province. Methodology: A qualitative phenomenological research approach was used to explore the factors leading to readmission of mental health care users. Purposive sampling was used to select participants of the study at the Thabamoopo Hospital. Twelve one-on-one semi-structured interviews were conducted. Ethical clearance was granted by the Medunsa Research Ethics Committee and permission to collect data was granted by the Limpopo Department of Health. The data were analysed through Tesch’s method of analysis. Results: The research findings indicate that the use of substances, non-adherence to psychiatric medication, the nature of the illness and social problems contributes to readmission of mental health care users. Conclusion and recommendations: In order to deal with factors related to re-admission of mental health care users, the mental health care practitioners, mental health care users and their families must be involved and work together.

MCur / Department of Advanced Nursing Science / Background- Family support is the most important milieu for the treatment and rehabilitation for mental health care users. However, there are cases that are reported where mental health care users are rejected by their family members worldwide. Vhembe District is no exception. Purpose-The study determined factors affecting family members’ support of their state patients in Hayani hospital, Vhembe District, Limpopo Province. Methodology- The study adopted a qualitative design which was explorative, descriptive and contextual in nature. Non-probability purposive sampling method was used to sample 09 family members with state patients at Hayani Hospital from the entire population. Data was collected through in-depth individual interviews and analysed through Techs method of coding. Ethical considerations and measures to ensure trustworthiness were followed throughout the study. Results- Data revealed two themes from namely, psychological factors and sociological factors affecting family members’ support. Recommendations- This study recommends on developing a model of support for family members’ with state patients at Hayani hospital. This study also recommends that department of health should consider meetings with family members. / NRF

Magister Curationis - MCur / Psychiatric nurses are known for their person-centred care approach that offers help through a therapeutic communication approach. In South African nursing, a Professional Nurse is a nurse whose role include but not limited to conducting a comprehensive and holistic health assessment on clients of all age groups, with complex health problems, determines the health needs of the community, early detection, diagnosis, treatment and appropriate referral to higher levels of care.

PHDPH / Department of Public Health / Family involvement in caring for mentally ill patients in long-term mental healthcare institutions is defined as a strategy in which family members and long-term healthcare professionals become partners to provide the best possible care for a person with mental illness. The study seeks to develop a model to promote family involvement in long-term mental health care institutions in Limpopo Province, South Africa. Mixed methods was used. Unstructured interviews were conducted with 21 family members and 6 focused group discussions with MHCUs in qualitative phase. Self-administered questionnaires were used to collect data from 360 nurses in the quantitative phase. Data was analysed independently of which convergent analytic approach was used to merge the two data sets. iv The study reports that the MHCUs’ attitudes towards families contribute to poor involvement by family members in the care/visit of the MHCUs while admitted in long-term mental health care. The rejection of the MHCUs also came up strongly during data analysis. Nurses perceived that insufficient family involvement hinders the provision of mental health care services. Eight steps in the Walker and Avant Method were adapted to clarify and distinguish the definition of the main concepts. A model to promote family involvement was conceptualised using the six areas as described by Dickoff, James and Wiedenbach (1968). A model was validated against its rationale and purpose of the study. Justification on the contribution of the family involvement in mental health care revealed that “family involvement in caring for MHCUs” is an engagement and encourages family members to participate in the diagnosis, treatment and recovery process. Study recommended that a developed model should be implemented in health establishments providing mental health services. Policies should be reviewed to include activities which the families should be notified of immediately the mentally ill patient is declared to receive mental health care, treatment and rehabilitation. Developed model should be piloted and evaluated to identify areas that will further improve the quality of mental health services. / NRF

Department of Advanced Nursing Science / MCur

MCur / Department of Advanced Nursing Science / Background: In South Africa the Mental Health Care Act No. 17 of 2002 direct district hospitals to render 72-hour assessment of the MHCU’s. In Vhembe district 72- hour assessment is implemented in public general hospital. Purpose: The study determined the experiences of family members regarding 72-hour assessment admission of MHCU’s at selected hospital in Vhembe District. Methodology: The research design was qualitative, exploratory, descriptive and contextual in nature. The study population consisted of the family members of the MHCU’s admitted for 72-hour assessment. Purposive sampling was used to select 10 family members. This study used in-depth individual interviews to collect data until data saturation was reached and analysed using Tesch’s steps. Ethical consideration and measures to ensure trustworthiness were given attention to throughout the study. Results: Three themes emerged from analysed data which is negative experiences of family’s members, family member’s experience on coping mechanism and structural constraints. Recommendations: This study recommends further research study on the development of a model to support the family members in their caregiving role The study recommends further research study on the experiences of the health care professional regarding 72-hour assessment of a MHCU’s / NRF