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Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Magister Curationis - MCur / Background: Patient satisfaction is a well-researched area in general medicine worldwide, yet a full exploration of patient satisfaction amongst psychiatric patients appears to be lacking in South Africa. Patient satisfaction has become important because of the awareness of the patient’s human rights. There is an increasing practice of applying a consumer viewpoint to health care, while safeguarding patients’ rights and taking their views into account. This has been brought about by the inception of the Mental Health Care Act no. 17 of 2002.Purpose: The purpose of this study was to describe psychiatric inpatients’ satisfaction with the care provided in a psychiatric hospital in Cape Town.Objectives : (1) To describe the psychiatric inpatients’ satisfaction with the care provided in a psychiatric teaching hospital in terms of their views on the: care provided by nurses (interpersonal/nurse-patient- interaction and technical skills); care provided by doctors (interpersonal/doctor-patient interaction and technical skills; and the nature of the environment of care, and (2) to describe the psychiatric inpatients’ overall satisfaction with the care received in a psychiatric teaching hospital in terms of the: quality of care received from nurses and doctors; nature of the environment of care; and the likelihood of future utilization of the hospital serviceMethod/Design: The study made use of the quantitative descriptive design using the Primary Provider Theory of patient satisfaction and the Batho Pele Principles served as the conceptual framework. Data were collected from discharged patients using a self-administered questionnaire which was mailed to individual participants. A five and a four point Likert scales were used for different sections in the questionnaire.The study made use of 120 participants between the ages of 18 and 60.Findings: Generally respondents were satisfied with the care provided in thispsychiatric hospital. Greater satisfaction was noted on aspects of staff-patient interactions. Low satisfaction scores were observed on nurses’ technical aspects of care. The Batho Pele principles of information, openness and transparency,consultation, access and redress seem not to have been adhered to.Conclusions: General inpatient satisfaction in psychiatric hospital care was good.However, more innovative methods for improvement in the areas of dissatisfaction need to be developed. Special attention should be given to the implementation of the Batho Pele Principles and the protection of the patients’ rights.

Magister Curationis - MCur / Background: Patient satisfaction is a well-researched area in general medicine worldwide, yet a full exploration of patient satisfaction amongst psychiatric patients appears to be lacking in South Africa. Patient satisfaction has become important because of the awareness of the patient’s human rights. There is an increasing practice of applying a consumer viewpoint to health care, while safeguarding patients’ rights and taking their views into account. This has been brought about by the inception of the Mental Health Care Act no. 17 of 2002. Purpose: The purpose of this study was to describe psychiatric inpatients’ satisfaction with the care provided in a psychiatric hospital in Cape Town. Objectives : (1) To describe the psychiatric inpatients’ satisfaction with the care provided in a psychiatric teaching hospital in terms of their views on the: care provided by nurses (interpersonal/nurse-patient- interaction and technical skills); care provided by doctors (interpersonal/doctor-patient interaction and technical skills; and the nature of the environment of care, and (2) to describe the psychiatric inpatients’ overall satisfaction with the care received in a psychiatric teaching hospital in terms of the: quality of care received from nurses and doctors; nature of the environment of care; and the likelihood of future utilization of the hospital services. Method/Design: The study made use of the quantitative descriptive design using the Primary Provider Theory of patient satisfaction and the Batho Pele Principles served as the conceptual framework. Data were collected from discharged patients using a self-administered questionnaire which was mailed to individual participants. A five and a four point Likert scales were used for different sections in the questionnaire. The study made use of 120 participants between the ages of 18 and 60. Findings: Generally respondents were satisfied with the care provided in this psychiatric hospital. Greater satisfaction was noted on aspects of staff-patient interactions. Low satisfaction scores were observed on nurses’ technical aspects of care. The Batho Pele principles of information, openness and transparency,consultation, access and redress seem not to have been adhered to. Conclusions: General inpatient satisfaction in psychiatric hospital care was good. However, more innovative methods for improvement in the areas of dissatisfaction need to be developed. Special attention should be given to the implementation of the Batho Pele Principles and the protection of the patients’ rights.

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Although the effectiveness of assertive training has been investigated with a wide variety of clinical and non-clinical populations, few studies have investigated the effectiveness of these techniques with prison inmates. This study investigated the use of symbolic modeling and behaviour rehearsal to increase assertive skills and.decrease inappropriate aggressiveness with prison inmates. Thirty male inmates volunteered for a four week assertive training programme and were randomly assigned to a modeling, behaviour rehearsal, and a placebo control group. Ten other subjects were used as a test-retest control group. The modeling group received videotape-mediated modeling in which positive and negative assertions were demonstrated to 16 standardized situations. The behavioural rehearsal group received opportunities to shape and practice appropriate assertions to the same situations without the aid of viewing filmed models. The placebo control group viewed discussion films and the test-retest group received no treatment intervention. Self-reported measures, in-laboratory behavioural ratings, and in vivo behavioural assessments were used to assess changes in assertiveness, aggressiveness, and anxiety. Results indicated that inmates in the treatment groups significantly increased their verbal assertive skills (i.e., verbal content), but not their non-verbal skills (i.e., eye contact, latency, loudness). The efficacy of assertive training techniques in regard to their differential impact on verbal and non-verbal skills components and aggressiveness are discussed. On in vivo behavioural measures of assertiveness observed on the wards no differences resulted between treatments and controls. This indicated that verbal assertiveness learned in training did not generalize to other unfamiliar situations. Also the behavioural changes in the laboratory occurred without corresponding changes in self-reported assertiveness. The discrepancy between findings as measured by in-laboratory assessments and in vivo assessments is discussed in terms of generalization of skills environment receptivity to change, and other factors responsible for the differences. All the response components were affected by the particular type of situation presented. Assertiveness changed as a function of social-interpersonal context of positive feeling siutations, negative hostile situations, and situations simulated inside and outside the prison setting. These findings suggest that future investigations ought to develop methodologies for identifying the environmental stimuli which influence assertiveness in order to train clients in situations related to their assertive deficits. / Arts, Faculty of / Psychology, Department of / Graduate

Thesis (M.S.)--Boston University

Background: Persons treated during compulsive care are in a vulnerable situation. Caring for someone against their will involves great responsibility and places high demands on the staff's psychiatric skills, empathy and ability to interpersonal relationships. Many people who have been treated under compulsive psychiatric care are critical to the health care content and its execution. Aim: The aim of the studie was to describe people's experiences of compulsive care in Swedish psychiatric hospital care. Method: A qualitative study of 15 blogs with inductive approach and descriptive design was chosen. The material from the blogs has been analyzed with inspiration from content analysis. Results: The result was subdivided into three categories; A care process characterized by powerlessness, fear and ambivalence, Interaction and participation on the terms of care and Meaningful environmental factors. Conclusion: The result described both positive and negative experiences from compulsive care. The care process was often described as difficult to handle and included a great powerlessness. There was a great dissatisfaction regarding communication, information and personal treatment. The conclusion is that if persons are informed of what the compulsive care will entail and what is expected of them, the chances are higher that they will feel respected and that their wellbeing generally improves during the care period. If the person's autonomy is considered, the experience of an unequal power relationship in healthcare and in the meeting with healthcare professionals changes.