Thesis (Ed.D.)--Teachers College, Columbia University, 1975. / Typescript; issued also on microfilm. Sponsor: Elizabeth M. Maloney. Dissertation Committee: David E. Wilder. Includes tables. Includes bibliographical references (leaves 114-117).

D.Cur. (Community Nursing Science) / Aggression becomes such a part of people’s daily lives that it is viewed as normal. As in the society nursing students at a higher education institution (HEI) also experience aggression in their lives. This exposure to aggression is of concern as it can be a possible obstacle in the personal and professional development and interpersonal relationships of the nursing students. The essence of this concern is that nurse educators need to gain knowledge of, insight into and awareness of the aggression experienced by nursing students to empower these students to manage aggression in their lives. The purpose of this study was to develop and describe a model as a frame of reference to facilitate the health of nursing students at an HEI in Johannesburg, South Africa, who experience aggression in their lives. The objectives of this study were as follows:  To explore and describe the experience of nursing students at an HEI in Johannesburg of aggression in their lives.  To generate a model from the results that will facilitate the promotion of health of the nursing students at an HEI in Johannesburg who have experienced aggression.  To formulate strategies for the implementation of the model.The research design was theory-generative, qualitative, exploratory, descriptive and contextual in nature. Nursing students were purposefully sampled as they added to the richness of the data collected for the purpose of this research. Data was collected firstly through respondents drawing a picture and writing a self-reporting story, and secondly, through phenomenological interviews. Data analysis in this research was done by means of Tesch’s method of identifying themes and categories as described by Creswell. Ethical considerations were adhere to throughout the research and consent was obtained from the nursing students participating in the research. Lincoln and Guba’s method of trustworthiness was used. Two themes with categories were identified that reflected the nursing students’ experience of aggression in their lives. The first theme is that the nursing students experienced aggression as an integral part of their life and viewed it as a normal part of their life. The second theme is that nursing students experienced aggression as detrimental to themselves as a whole person and their interpersonal relationships. A model as a frame of reference to facilitate the health of the nursing students who have experienced aggression to self-manage aggression constructively,was developed. The findings of this research are relevant to the world of nursing practice, nursing education and research.

Thesis (Ed.D.)--Teachers College, Columbia University, 1975. / Typescript; issued also on microfilm. Sponsor: Elizabeth Maloney. Dissertation Committee: Mary Ramshorn. Includes bibliographical references (leaves 112-116).

D.Cur. (Psychiatric Nursing Science) / The researcher was involved in the clinical accompaniment of student nurses working with mentally challenged individuals during their psychiatric nursing practical training. In her role as advanced psychiatric nurse educator, she noticed that student nurses experienced working with mentally challenged individuals as a challenging working context. It created intense emotional discomfort for the student nurses, especially during their initial exposure to the relevant individuals. During the student nurses' last day of working with these individuals, they reflected with the advanced psychiatric nurse educator on their emotional growth and enrichment and how this experience had changed their views of life. Ineffective management of emotional discomfort may lead to emotional exhaustion or burnout and reflect negatively on a person's mental health. The main purpose of this research was to explore and describe the experiences of student nurses working with mentally challenged individuals. Subsequently, to develop, describe and write guidelines to operationalise and evaluate a model for the advanced psychiatric nurse educator to facilitate the mental health of student nurses working with mentally challenged individuals. A qualitative, explorative, descriptive, contextual and theory-generating research design was utilised to achieve the abovementioned purpose. The development of the model comprised four steps. Step one consisted of a concept analysis including identification and definition of central concepts in the model. A concept analysis was done by exploring and describing the experiences of student nurses working with mentally challenged individuals. Two focus groups, naive sketches, reflective journals, a reflective letter and field notes were used to explore their experiences. Focus groups were audiotaped as well as videotaped. Verbal consent was given by the student nurses to be videotaped and a letter of consent was signed to give permission for audiotaping of the focus groups. The audio tapes were transcribed verbatim. The video tapes were only used by the transcriber when she could not hear the sound on the audio tapes clearly. An independent coder utilised Tesch's method of open-coding to code and analyse the data. A consensus was reached between the researcher and the independent coder with regard to the themes and catogories represented by the data. During the concept analysis, engagement on a deeper emotional level was identified as the central concept. Step two consisted of the relationship statements of the model. During step three, a model for the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals was described. The structure of the model clarified the purpose, assumptions and context. The central concepts were defined and the relationship statements between the central and essential concepts were explained. The structure of the model focused on the relationship-, workingand termination phases within the process of engagement on a deeper emotional level. In step four guidelines were described to operationalise the model in practice. The model, as framework of reference for the advanced psychiatric nurse educator, focused on the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals. The process description of the model differentiated between three phases: the relationship phase, the working phase and the termination phase. Guidelines for the operasionalisation of the model focused on the objective of each phase as well as the strategy of actions for each different phase.

The use of simulation as a clinical learning activity is growing in nursing programs across the country. Using simulation, educators can provide students with a realistic patient situation using mannequins or actors as patients in a simulated environment. Students can practice multiple aspects of patient care without the risk of making mistakes with real patients, and faculty can reinforce course objectives and evaluate student learning. Because of the technology, the environment, and the methods by which simulation is implemented, it may cause anxiety in learners, which may interfere with the learning process. Anxious students may miss an opportunity for learning valuable aspects of nursing care that are reinforced in simulation. This paper will describe a study of the student perspective on simulation, particularly related to the anxiety experienced by many learners. Nursing students in a baccalaureate program who participate in simulation in their clinical courses were recruited for the study, which consisted of a survey and a focus group. Participants were asked to rate nineteen aspects of simulation in regards to the feelings they elicit, from confidence to anxiety. The survey, completed by 73 of the 178 eligible participants, also included open-ended questions in which students could elaborate on their responses. A focus group was held after the survey, during which nine volunteer participants were asked further questions about their feelings and reactions in simulation, specifically as related to their effect on learning. During a facilitated discussion, they also offered suggestions for interventions that they believed would decrease their anxiety and improve the learning environment in simulation. After an analysis of the data, a "comfort-stretch-panic" model (Palethorpe & Wilson, 2011) emerged as a useful framework for understanding the student perspective. Students in the "stretch" zone, in which they perceived a manageable amount of stress, were motivated to perform and experienced optimal learning from the simulation session. The student suggestions for interventions which would aid their learning may be useful for transitioning them into the "stretch" zone, and should be considered as potential tools in simulation practice.

Este estudo elegeu para objeto de investigação o fazer, o saber e o saber-fazer de quinze agentes de enfermagem de nível médio que desenvolvem atividades assistenciais no Centro de Atenção Psicossocial II Prof. Luís da Rocha Cerqueira, sede do Programa de Integração Docente Assistencial em Saúde Mental da Secretaria de Estado da Saúde e Universidade de São Paulo. A escolha das agentes deu-se mediante a crença de que o grupo protagoniza a ação e o trabalho da enfermagem em saúde mental no campo psicossocial porque é quem prevalentemente oferece ação de saúde mental no cenário de estudo. Esta pesquisa utilizou a Oficina de Trabalho como procedimento metodológico para a captação, análise e reconstrução do fazer e do saber das agentes de enfermagem. A construção compartilhada do conhecimento indicou duas dimensões da produção de produtos de saúde. Na primeira dimensão as agentes de enfermagem de nível médio produzem e oferecem ação de saúde mental mediatizada pelo fazer impregnado de saber alinhado ao campo psicossocial do coletivo institucional e compartilham a autoria da ação de forma subalternizada ao agente com formação de nível superior. A segunda dimensão do fazer agrega significado à ação de saúde e permite a apropriação da autoria da produção de produtos de saúde, configurando o trabalho da enfermagem: o cuidado em si de enfermagem em saúde mental. Os resultados indicam ainda uma prevalência de produção e oferta de produtos de saúde que atinge o usuário individual, no interior da instituição, indicando a necessidade institucional de buscar aprofundamento e coerência aos pressupostos do campo psicossocial no que tange à articulação do serviço com o território, à inclusão de ação de saúde para familiares e à ampliação da produção de produtos na esfera da vertente crítica da reabilitação psicossocial. A Oficina de Trabalho revela-se um instrumento potente para a particular aquisição de consciência crítica quando amplia o repertório teórico das pesquisadas, eleva o relato de experiência para o patamar do saber construído coletivamente e promove a mudança objetiva da posição das agentes de enfermagem no cenário do poder institucional. / The object of this study was the to do, the knowledge and the how to do of the fifteen medium level nursing agents who perform assistance activities in the Center of Psychosocial Attention II, Prof. Luis da Rocha Cerqueira, home office of the Program of Academic Assistance Integration in Mental Health of the State Health Secretary and University of São Paulo. The agent choice was performed according to the belief that the group performs the action and the nursing work in mental health in the psychosocial field because this is the individual who predominantly offers action in mental health in the study environment. This research used the Work Shop as a methodological procedure to achieve, analyze and reconstruct the to do and the knowledge of the nursing agents. The shared construction of the knowledge showed two dimensions to produce health products. In the first dimension, the medium-level nursing agents produce and offer intermediated mental health action by the do impregnate of knowledge aligned to the psychosocial field of the institutional collective and share the authorship in a subordinated way to the academic agent. The second dimension of the to do adds meaning to health action and allows the appropriation of the authorship of the production of health products, determining the nursing work: the care itself of nursing in mental health. The results showed a prevalence of production and offering of health products which reaches the individual user, within the institution thus indicating the institutional need of search for deepening and coherence of purposes in the psychosocial field regarding articulation of the service with the territory, inclusion of action of health action for relatives and to expand the production of products in the critical sphere of the psychosocial rehabilitation. The Workshop showed to be a strong instrument to specifically acquire critical consciousness when expanding the theoretical repertory of the investigated, raising the experience report up to the level of the knowledge collectively constructed and to promoting an objective change of the nursing agent’s position in the institutional power environment.

Esta é uma pesquisa qualitativa cujo objeto de estudo são as necessidades de saúde da perspectiva de usuários de um serviço comunitário de saúde mental. A finalidade do estudo é contribuir para o fortalecimento da Reforma Psiquiátrica brasileira, propondo o conceito de necessidades de saúde como um instrumento para orientação da organização dos serviços e dos processos de trabalho em saúde mental. Os objetivos da pesquisa são identificar o entendimento dos usuários do serviço sobre suas necessidades de saúde, verificar se são satisfeitas pelo serviço e sistematizar as compreensões dos usuários de forma a contribuir para a organização das práticas no serviço. O cenário de estudo é o Centro de Atenção Psicossocial Itaim Bibi da Secretaria Municipal de Saúde de São Paulo que opera um projeto terapêutico baseado nos pressupostos da Reforma Psiquiátrica. Participaram deste estudo cinco usuários-trabalhadores do Projeto de Geração de Trabalho e Renda O Bar BibiTanTã, resultado da Cooperação Técnica entre o CAPS Itaim Bibi, a Área Temática de Enfermagem em Saúde Mental da Escola de Enfermagem da Universidade de São Paulo e a Associação Franco Basaglia. Os dados empíricos foram coletados por meio de entrevista semi-estruturada e analisados segundo a técnica de análise de enunciação. Os resultados apontam contradição com relação à satisfação das necessidades de saúde dos usuários. A análise das entrevistas demonstra que o serviço desenvolve projetos e ações que respondem às necessidades propriamente humanas e às necessidades alienadas de parte dos usuários, entretanto, na fala dos sujeitos, não está claro se a ação do serviço é voltada explicitamente para a apreensão e satisfação das necessidades, pois enquanto algumas são satisfeitas, outras parecem não encontrar espaço para serem expressas. Ressaltamos a importância dos projetos de geração de renda, baseados a lógica da Economia Solidária, pela diferença que faz na vida dos usuários-trabalhadores e, principalmente, por ser um importante instrumento para a efetivação da Reforma Psiquiátrica / This is a qualitative research whose object of study are the health necessities of users’ perspectives in a mental health communitarian service. The purpose of this study is to contribute to the strengthening of the Brazilian Psychiatric Reform, introducing the health necessities concept as an instrument for the directions of mental health work processes and services’ organization. The research objectives are the identification of the service user understandings about their health necessities, the verification of their performance by the service and the classification of users comprehensions in order to help the practice’s organization in the service. The scenery of study is the Psychosocial Care Center in Itaim Bibi (CAPS) of the Health Department in the City of São Paulo which performs a therapeutic project based on the pretext of the Psychiatric Reform. Five user-workers from the Income and Work Creation Project O Bar BibiTantã participated on this study as a result of the Technical Cooperation among the CAPS Itaim Bibi, the Nursing Thematic Area in Mental Health of the Nursing School from Universidade de São Paulo and the Franco Basaglia Association. The empiric data were gathered through semi-structured interview and they were analyzed according to the enunciation analysis technique. The results show a contradiction related to the satisfaction of user’s health necessities. The interview analysis demonstrates that the service develops projects and actions that supply the human’s proper necessities and some user’s private necessities as well, however it is not clear in their talk if the service action is turned directly to the apprehension and performance of these necessities because while some are performed others seem to find no place to be expressed. We emphasize the importance of Income Creation Projects based on the logic of Assisting Economy because of the difference they make in the user-worker’s lives and mainly for being an important instrument for the accomplishment of the Psychiatric Reform

Este estudo elegeu para objeto de investigação o fazer, o saber e o saber-fazer de quinze agentes de enfermagem de nível médio que desenvolvem atividades assistenciais no Centro de Atenção Psicossocial II Prof. Luís da Rocha Cerqueira, sede do Programa de Integração Docente Assistencial em Saúde Mental da Secretaria de Estado da Saúde e Universidade de São Paulo. A escolha das agentes deu-se mediante a crença de que o grupo protagoniza a ação e o trabalho da enfermagem em saúde mental no campo psicossocial porque é quem prevalentemente oferece ação de saúde mental no cenário de estudo. Esta pesquisa utilizou a Oficina de Trabalho como procedimento metodológico para a captação, análise e reconstrução do fazer e do saber das agentes de enfermagem. A construção compartilhada do conhecimento indicou duas dimensões da produção de produtos de saúde. Na primeira dimensão as agentes de enfermagem de nível médio produzem e oferecem ação de saúde mental mediatizada pelo fazer impregnado de saber alinhado ao campo psicossocial do coletivo institucional e compartilham a autoria da ação de forma subalternizada ao agente com formação de nível superior. A segunda dimensão do fazer agrega significado à ação de saúde e permite a apropriação da autoria da produção de produtos de saúde, configurando o trabalho da enfermagem: o cuidado em si de enfermagem em saúde mental. Os resultados indicam ainda uma prevalência de produção e oferta de produtos de saúde que atinge o usuário individual, no interior da instituição, indicando a necessidade institucional de buscar aprofundamento e coerência aos pressupostos do campo psicossocial no que tange à articulação do serviço com o território, à inclusão de ação de saúde para familiares e à ampliação da produção de produtos na esfera da vertente crítica da reabilitação psicossocial. A Oficina de Trabalho revela-se um instrumento potente para a particular aquisição de consciência crítica quando amplia o repertório teórico das pesquisadas, eleva o relato de experiência para o patamar do saber construído coletivamente e promove a mudança objetiva da posição das agentes de enfermagem no cenário do poder institucional. / The object of this study was the to do, the knowledge and the how to do of the fifteen medium level nursing agents who perform assistance activities in the Center of Psychosocial Attention II, Prof. Luis da Rocha Cerqueira, home office of the Program of Academic Assistance Integration in Mental Health of the State Health Secretary and University of São Paulo. The agent choice was performed according to the belief that the group performs the action and the nursing work in mental health in the psychosocial field because this is the individual who predominantly offers action in mental health in the study environment. This research used the Work Shop as a methodological procedure to achieve, analyze and reconstruct the to do and the knowledge of the nursing agents. The shared construction of the knowledge showed two dimensions to produce health products. In the first dimension, the medium-level nursing agents produce and offer intermediated mental health action by the do impregnate of knowledge aligned to the psychosocial field of the institutional collective and share the authorship in a subordinated way to the academic agent. The second dimension of the to do adds meaning to health action and allows the appropriation of the authorship of the production of health products, determining the nursing work: the care itself of nursing in mental health. The results showed a prevalence of production and offering of health products which reaches the individual user, within the institution thus indicating the institutional need of search for deepening and coherence of purposes in the psychosocial field regarding articulation of the service with the territory, inclusion of action of health action for relatives and to expand the production of products in the critical sphere of the psychosocial rehabilitation. The Workshop showed to be a strong instrument to specifically acquire critical consciousness when expanding the theoretical repertory of the investigated, raising the experience report up to the level of the knowledge collectively constructed and to promoting an objective change of the nursing agent’s position in the institutional power environment.

Esta é uma pesquisa qualitativa cujo objeto de estudo são as necessidades de saúde da perspectiva de usuários de um serviço comunitário de saúde mental. A finalidade do estudo é contribuir para o fortalecimento da Reforma Psiquiátrica brasileira, propondo o conceito de necessidades de saúde como um instrumento para orientação da organização dos serviços e dos processos de trabalho em saúde mental. Os objetivos da pesquisa são identificar o entendimento dos usuários do serviço sobre suas necessidades de saúde, verificar se são satisfeitas pelo serviço e sistematizar as compreensões dos usuários de forma a contribuir para a organização das práticas no serviço. O cenário de estudo é o Centro de Atenção Psicossocial Itaim Bibi da Secretaria Municipal de Saúde de São Paulo que opera um projeto terapêutico baseado nos pressupostos da Reforma Psiquiátrica. Participaram deste estudo cinco usuários-trabalhadores do Projeto de Geração de Trabalho e Renda O Bar BibiTanTã, resultado da Cooperação Técnica entre o CAPS Itaim Bibi, a Área Temática de Enfermagem em Saúde Mental da Escola de Enfermagem da Universidade de São Paulo e a Associação Franco Basaglia. Os dados empíricos foram coletados por meio de entrevista semi-estruturada e analisados segundo a técnica de análise de enunciação. Os resultados apontam contradição com relação à satisfação das necessidades de saúde dos usuários. A análise das entrevistas demonstra que o serviço desenvolve projetos e ações que respondem às necessidades propriamente humanas e às necessidades alienadas de parte dos usuários, entretanto, na fala dos sujeitos, não está claro se a ação do serviço é voltada explicitamente para a apreensão e satisfação das necessidades, pois enquanto algumas são satisfeitas, outras parecem não encontrar espaço para serem expressas. Ressaltamos a importância dos projetos de geração de renda, baseados a lógica da Economia Solidária, pela diferença que faz na vida dos usuários-trabalhadores e, principalmente, por ser um importante instrumento para a efetivação da Reforma Psiquiátrica / This is a qualitative research whose object of study are the health necessities of users’ perspectives in a mental health communitarian service. The purpose of this study is to contribute to the strengthening of the Brazilian Psychiatric Reform, introducing the health necessities concept as an instrument for the directions of mental health work processes and services’ organization. The research objectives are the identification of the service user understandings about their health necessities, the verification of their performance by the service and the classification of users comprehensions in order to help the practice’s organization in the service. The scenery of study is the Psychosocial Care Center in Itaim Bibi (CAPS) of the Health Department in the City of São Paulo which performs a therapeutic project based on the pretext of the Psychiatric Reform. Five user-workers from the Income and Work Creation Project O Bar BibiTantã participated on this study as a result of the Technical Cooperation among the CAPS Itaim Bibi, the Nursing Thematic Area in Mental Health of the Nursing School from Universidade de São Paulo and the Franco Basaglia Association. The empiric data were gathered through semi-structured interview and they were analyzed according to the enunciation analysis technique. The results show a contradiction related to the satisfaction of user’s health necessities. The interview analysis demonstrates that the service develops projects and actions that supply the human’s proper necessities and some user’s private necessities as well, however it is not clear in their talk if the service action is turned directly to the apprehension and performance of these necessities because while some are performed others seem to find no place to be expressed. We emphasize the importance of Income Creation Projects based on the logic of Assisting Economy because of the difference they make in the user-worker’s lives and mainly for being an important instrument for the accomplishment of the Psychiatric Reform

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression and the GAD-7 for anxiety, along with additional demographic information and mental health service usage questions, was sent to and completed by participants. A total of n = 173 responses were received. Of these responses n = 99 or 57.2 percent were nursing students, a participation rate of 9.6 percent, and n = 74 or 42.8 percent were pre-nursing students. The research revealed that depression and anxiety scores were above the cutoff for moderate depression and anxiety in both groups, as well as identified a deficit in availability of mental health resources, with over 10 percent of students unable to access counseling or psychiatric services. Contraindicatory to literature, which predicted improving mental health in the progression through university studies, this study reveals a variable and even worsening trajectory of mental health as students transition into the nursing program and progressed through college.