The study sought to gain an in-depth understanding of the knowledge and skills regarding rehabilitation of mental health care users of nurses who work at a psychiatric rehabilitation centre, in order to design a continuing professional development plan for registered and enrolled nurses. The researcher used a qualitative, exploratory descriptive design to explore the knowledge and skills of nurses who practise in a psychiatric rehabilitation centre dealing with the rehabilitation of mental health care users. Four themes emerged from the data that were collected from four focus groups: knowledge of the rehabilitation process; the need for continuing professional development; nursing skills required for the implementation of psychiatric rehabilitation and means of communication within psychiatric rehabilitation. The researcher devised a continuing professional development plan, including topics on the management of the mentally ill, the problems associated with mental illness and rehabilitation appropriate to the mental illness. / Health Studies / M. A. (Health Studies)

D.Cur. / There is currently lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services of the Gauteng Province. This lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services, is associated with her supervisors who are the psychiatric nurse managers. The purpose of this research was to develop and describe a model that could be implemented to guide the mobilization of the advanced psychiatric nurse as a resource person in the mental health services in order to facilitate her mental health. The research also focused on developing guidelines for the implementation of the model for the mobilization of the advanced psychiatric nurse as a resource person. The model: "Mobilization of the advanced psychiatric nurse as a resource person: an interactive process", together with its operational guidelines was developed by using a theory generative design, that is, qualitative, explorative, descriptive and contextual in nature. This model was developed according to Chinn and Kramer's (1995) approach to theory generation, namely: identification of the central concepts for the model by conducting a field study to explore and describe the views of the advanced psychiatric nurse and those of the psychiatric nurse managers with regard to the mobilization of the advanced psychiatric nurse as a resource person in the mental health services of Gauteng; analysing the data gathered through focus groups interviews from the sample of the advanced psychiatric nurses and form the sample of psychiatric nurse managers using Strauss and Corbin's (1990) open, axial, and selective coding approach to guide data analysis; analysing the data by identifying, defining, classifying the concepts and placing them into relationship with each other to form relationship statements as the conceptual framework for the model; describing the model using strategies proposed by Chinn and Kramer (1995) and then subjecting the model to evaluation by experts in theory generation; describing the guidelines for the implementation of the model in the clinical setting.

Background: The experience of stress and anxiety in nursing students can reach a high level because of fear of making an error or causing fatal harm to a patient. Unmitigated stress and anxiety can hinder learning and the performance of psychomotor skills in the clinical setting, eventually affecting patient care.Aim: This study aimed to examine anxiety, stress, self-efficacy for nursing clinical skills, and self-efficacy for therapeutic communication in undergraduate nursing students who were randomized to either an intervention with a standardized patient or the comparison group who participated in role play. Method: An experimental study with randomization was conducted with prelicensure nursing students (N = 87) recruited from associate and bachelor’s degree nursing programs in the Finger Lakes region of New York State, using the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), Clinical Skills Self-Efficacy Scale (CSES), and Self-Efficacy in Therapeutic Communication (SETC). Data collection occurred at preintervention, postintervention, and at follow-up, approximately 2 weeks after the intervention. Results: The first report describes the development of the Self-Efficacy for Therapeutic Communication Scale (SETC) developed by the principal investigator and used in this study. Exploratory factor analyses with a Varimax rotation of the 15 items yielded two factors accounting for 51.3% of the variance. Two subscales were formed by summing the items loading above .4 on each factor. The first subscale was Communication Techniques, which included 9 items and had a Cronbach’s alpha of .91 The second subscale was Intuitive Practices with 6 items and a Cronbach’s alpha of .79. The correlation between the two subscales was r = .67 (p < .001). Test-retest reliability for the scale from pre- to posttest was .68, pre- to follow-up was .41, and posttest to follow-up was .68. In the second report, Pearson’s r was used to determine that state anxiety, trait anxiety, and stress were highly correlated with each other, with a range of correlations, r = .53 to .91, p < .001. Inverse contemporaneous correlations were found for trait anxiety and for stress with self-efficacy for clinical skills at all time points, whereas state anxiety was inversely related to self-efficacy for clinical skills at posttest and follow-up. Inverse correlations for self-efficacy for therapeutic communication were statistically significant with state anxiety, trait anxiety, and stress, but only at posttest. In the third report, mixed Analysis of Variances (ANOVAs) determined that there was a statistically significant interaction between time and group on state anxiety scores, F(2, 170) = 3.551, p = .031, η2 = .040. Simple main effects analyses showed that the intervention and comparison group means did not differ at any of the three testing times. Paired samples t tests indicated that the scores on anxiety in the intervention group did not show any statistically significant change over time, whereas anxiety in the comparison group was significantly higher at follow-up than at any other time. Mixed ANOVAs showed no interaction between time and groups for self-efficacy for clinical skills or for self-efficacy for therapeutic communication. Results indicated that the intervention and comparison group means on self-efficacy for clinical skills and self-efficacy for therapeutic communication improved over time. Both intervention and comparison groups reported increased self-efficacy in clinical skills and therapeutic communication at follow-up data collection. In addition, two separate mixed ANOVAs were performed to determine if stress had a moderating effect on the intervention. Students in the high stress group (PSS greater than 18), did not experience a change in anxiety over time, while the comparison group of participants with low stress (scores less than or equal to 18), had significant changes in anxiety from pretest to follow-up and posttest to follow-up, while the intervention group did not. Conclusion: Stress and anxiety can have detrimental effects on nursing students’ self-efficacy for clinical skills and self-efficacy for therapeutic communication. Prioritizing and mitigating the effects of stress and anxiety to improve self-efficacy in nursing students is one way of preparing nursing students for competency-based education, as outlined in the American Association of Colleges of Nurses, The Essentials: Core Competencies for Professional Nursing Education. Throughout the Domains of The Essentials, therapeutic communication is found in 13 competencies, indicating that this once considered soft skill, is a critical skill required for safe patient care. Teaching methods that include interactions with standardized patients and managing difficult conversations can be helpful for the nursing student to experience in pre-clinical preparation. Keywords: Anxiety, self-efficacy, standardized patients, therapeutic communication, clinical nursing skills