Thesis (M.S.)--University of Michigan, 1990.

THESIS (D.N.P. (Doctor of Nursing Practice))--School of Nursing, University of San Francisco, 2010. / Bibliography: leaves 61-67.

Thesis (Ph. D.)--University of California, San Diego, 2010. / Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references.

Thesis (H. Sc. D.)--University of Sydney, 2008. / Title from title screen (viewed Nov. 13, 2008) Submitted in fulfilment of the requirements for the degree of Doctor of Health Sciences to the Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

D.Cur. (Psychiatric Nursing) / Please refer to full text to view abstract

M.Cur. (Psychiatric Mental Health Nursing) / Injuries suffered by nursing personnel as a result of aggression by mental health care users are on the increase. The psychiatric nurses and assistant nurses working in a psychiatric institution may suffer physical trauma, which gets healed over time with proper treatment, but the emotional scars are not attended to, hence some of the psychiatric nurses and assistant nurses working in a psychiatric institution do not cope. The impact of this trend is enormous and it is reflected in the health care service. The main purpose of this research study is to explore and describe the experiences of psychiatric nurses and assistant nurses who have been exposed to aggression by mental health care users while working in a psychiatric institution, in order to formulate guidelines to promote the mental health of these psychiatric and assistant nurses to. A qualitative, exploratory, descriptive and contextual research design was utilised in this study. There were two phases to the research, whereby phase one included the description and exploration of experiences of nurses who have been exposed to aggression by mental health care users in a public psychiatric hospital in Gauteng. In phase two, guidelines were formulated to promote the mental health of the nurses in this context. A purposive sampling method was used, since it provides information-rich cases for in-depth study. One-on-one in-depth phenomenological interviews were utilised to gather data. Lincoln and Guba’s approach to trustworthiness was adopted, and I employed the services of an independent coder - an experienced psychiatric nursing specialist - to assist. Thereafter a consensus discussion was held. Ethical principles were adhered to throughout the study. The findings of the research were discussed in the light of literature relevant to this research study and similar studies will be used to verify the findings. Tesch’s method of data analysis was utilised in analysing the data of this research study. The findings revealed that participants experience significant emotional distress as a result of both verbal and physical aggression by mental health care users. Aggressive behaviour was recognised by the participants as being the outcome of interplay between numerous interactional and contextual factors. Participants may at times, experience conflict between their job mandate – to care for the mental health care users – and their need for personal safety. This often results in a sense of ambivalence towards those they care for, as well as towards their job. The participants were of the opinion that they should be offered counselling or debriefing services by management after exposure to aggressive incidents in order to recuperate from the anxiety-provoking situation they encountered. They also mentioned that they do not receive enough training in handling aggressive mental health care users, hence at times they feel demotivated. Guidelines to facilitate the mental health of nursing personnel who have been exposed to aggression by mental health care users, were formulated and recommendations were made to psychiatric nursing practice, psychiatric nursing education and psychiatric research. Evaluation of the study was done and the role of an advanced psychiatric nurse in mobilising resources to facilitate the mental health of psychiatric nurses and assistant nurses working in a psychiatric institution who have been exposed to aggression by mental health care users, was outlined.

Magister Curationis / The aim of this study was to investigate vicarious trauma experienced by caregivers working with children in residential care, who were victims of sexual abuse or assault. The objectives of the study were to determine the occurrence of vicarious trauma among caregivers working with victims of sexual abuse or assault; to describe the experiences of caregivers working with children who were victims of sexual abuse; to describe the caregiver's experience of staff support within the facility. / South Africa

Please read the abstract in the section 00front of this document / Thesis (DPhil)--University of Pretoria, 2009. / Nursing Science / unrestricted

After 1994 with the inception of the South African Democratic Government, the health care delivery system was one of the areas that had to be reviewed. The vehicle for a comprehensive health care system was based on primary health care which encouraged people and patients to take responsibility for their health by being involved in all aspects of their care. For this purpose the Batho Pele principles were introduced, a concept which is informed by 8 principles, namely: consultation, service standards, access, courtesy, information, openness and transparency, redress and value for money. These principles are meant to restore the dignity and the rights of patients which are paramount in the Constitution of South Africa. (Constitution of South Africa 108 of 1996 Chapter 2) The nurses claim that since the introduction of the Batho Pele Principles, patients and their families have been “impossible” towards nurses, making unnecessary and sometimes impossible demands. The nurses also experience patients and their families as being informed of their “rights” but not of their responsibilities as patients. They were also unaware of the rights of the nurses. The objectives of the study were:- To explore and describe the experiences of professional nurses working in the outpatient departments of the introduction of the Batho Pele principles in state hospitals, and to Recommend guidelines that will enhance better understanding and implementation of the Batho Pele principles by the professional nurses. The study is founded on a qualitative research paradigm based on explorative, descriptive and contextual framework. The data was collected from focus groups from each hospital of the Port Elizabeth Hospital Complex. Each group consisted of four to six willing participants all of them were professional nurses who have worked at least five or more years in the outpatient department of the Port Elizabeth Hospital Complex. Data was collected via semi-structured audio-taped interviews together with the researcher’s field notes. Data analysis was done using Tesch’s data analysis spiral. The assistance of independent coder reinforced the truth value of the findings. Themes and subthemes emerged from the data that was collected and revealed that the professional nurses experienced that the Batho Pele Principles as a good policy, but that it was difficulty to uphold due to inadequate planning of health services prior to implementation of the Batho Pele Principles. They experience not getting from their management and they also experience that there was lack of discipline in their institutions. Based on these findings, guidelines that will recommend better implementation of the Batho Pele Principles by nurses were compiled by the researcher and future research in this regard was recommended.

This study investigated the relationship between cognitive development and children’s understanding of the hospital nurse’s role. A group of 35 hospitalized children with chronic conditions and without neurological deficits, aged 4 to 10 years, were given three tasks (i.e., the Nurse’s Role Task, the Balance Beam Task, and the Task of Intrapersonal Understanding), scored for developmental level using Case’s (1992) neo-Piagetian theory of cognitive development as a framework. A full sample of 4—year—olds was not pursued due to the distracting hospital environment which, in combination with the shorter attention span of the 4-year-olds, rendered the interviews extremely difficult to complete. Descriptive results indicated a moderately advanced understanding of the hospital nurse’s role by 8— and lO—year—olds, being on the order of one—third of a substage (i.e., approximately 8 months ahead in development), whereas 4— and 6—year—olds showed an age— appropriate level of understanding of the hospital nurse’s role. Analysis of Variance indicated a statistically significant effect for age on all three tasks (p < .01). Six levels of social—cognitive development in understanding the hospital nurse’s role were found, which were, in successive order: (1) Roles of the nurse as scripted actions (i.e., 4-year-old level), (2) Roles of the nurse as motivated action sequences (i.e., 6—year—old level), (3) Roles of the nurse as planned action sequences (i.e., 8— year—old level), (4) Roles of the nurse as generalized dispositions toward action (i.e., 10—year-old level), (5) Roles of the nurse as demonstrating logically planned decisions towards action (i.e., 12-year—old level), and (6) Roles of the nurse as demonstrating logically planned action sequences (i.e., 14—year—old level). Furthermore, results indicate that a few 6- and 8-year-olds and the majority of l0—year—olds could give an accurate description of the duties of the hospital nurse, that is, 1) nurses are there to help children, 2) nurses have a responsibility for the well-being of their patients, 3) nurses want to improve the physical and emotional health of their patients, 4) nurses also see their own shortcomings in their care for children and have good intentions, and 5) nurses are human and have their own feelings, thoughts, doubts, and ideas. Suggestions for future research have been provided in order to further improve communication between health care professionals and hospitalized children with chronic conditions. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate