D.Cur. / Lifecare, like any other corporate business, in the current environment, has to change all the time. Companies need new customers, innovative products, expanded market and cutting edge technologies. The Company has the potential to shape the behaviour, reinforce common beliefs, and encourage members to apply their efforts to accomplish important Company objectives of providing care for chronic mentally ill patients. The psychiatric nurses are therefore an essential requirement for the success of the Company in a competitive environment. On the other side, psychiatric nurses face the difficult task of confronting the challenges involved in the nature of care required among chronic psychiatric patients. Whilst striving for quality patient care, they find themselves faced with some breakdowns within the environment in which they are interacting, resulting in their resorting to negative media publicity. This type of publicity can lead to damaging the Company’s reputation and can retard the Company’s growth strategy, which the psychiatric nurses might not seem to understand. There was also high staff turnover which hampered quality patient care. This could also affect the Company in terms of what affects the competitiveness of the quality care which the Company aims to deliver. The researcher believes that for clinical care to take place, psychiatric nurses need to be in sound mental health and understand the dynamics within the Company in order to deal with it in an effective way. The following research questions posed were addressed in this research: • What are the psychiatric nurses’ experiences whilst being employed by the Company? • In what way can the formulation of the model be of assistance in the promotion of the psychiatric nurses’ mental health as an integral part of health? The research objectives were: • To explore and describe the experiences of the psychiatric nurses whilst employed by Lifecare.• To use the results to generate the concepts for the model that would serve as a framework for the psychiatric nursing specialist to facilitate the implementation of guidelines that would assist the psychiatric nurses to be in a sound mental state. • To describe the guidelines that would serve as a framework for operationalising the model in nursing education, psychiatric nursing practice and nursing research. Methods to ensure trustworthiness were ensured throughout this research. Ethical consideration as outlined in the Position Statements published by the Democratic Nursing Association of South Africa (1998: 2-21), was adopted. The researcher utilized the assumptions of the Theory for Health Promotion in Nursing in this research. This theory focuses on the whole person, that is, the mind, body and spirit as well as on the parameters of nursing and the beliefs about the person, health, illness and nursing. The emphasis in this theory is on mental health promotion of the psychiatric nurses within the Company. This research consisted of three stages as follows: In stage one a qualitative design was used to explore and describe the psychiatric nurses’ inner world experiences of the Company’s culture. Indepth semi-structured interviews were utilized to obtain data from these psychiatric nurses. These interviews were conducted by an independent interviewer, and were audio-taped. These were transcribed and were analysed by the researcher. Tesch (1990) in Cresswell (1994: 154) outlined eight steps, which are referred to as decontextualisation and contextualisation, which were adopted in analyzing the results. A description of the results was given. This was followed by literature control which highlighted the similarities to and contributions to this research. Themes that emerged highlighted the experiences that the psychiatric nurses had of the Company culture which affected their mental health. In stage two the research design and theory generation was employed to formulate a model which could be used in nursing education, nursing research and nursing practice. The model formulated was based on the resultsobtained on the inner world experiences of psychiatric nurses. A combination of stages of theory generation by Chinn and Kramer (1991:79-104) and Dickoff, James and Wiedenbach (1968: 431-434) were employed by the researcher to identify the central concepts that guided the identification of the main theme. A tentative model was formulated and was submitted to the independent experts for consultations and clarification. The model was named and presented in its final form to the independent experts. In stage three the researcher formulated the guidelines for operationalising the implementation of the model in clinical practice, nursing education and recommendations were made for further research.

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.

M. Curr. / Mental health challenges are a worldwide phenomenon, and more people are experiencing these challenges which are related to the life style and psychological stressors facing them. Addressing this burden is a challenge to health care providers, as some are influenced by their perceptions about mental illness in facing the demands made be society. Registered nurses who are not trained in psychiatric nursing do not have the appropriate background information or skill of how to cope with patients with mental health challenges even if they have undergone an introduction into nursing psychology at college. This increases their fears and anxieties when having to interact with these patients. The aim of this study is thus to explore the experiences of registered nurses in interaction with patients with mental health challenges so as to be able to formulate and describe guidelines to facilitate the registered nurses mental health.

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

M.Cur. (Psychiatric Nursing) / Psychiatric nursing forms part of basic nursing education in South Africa which is done in four years, either at diploma level or degree level. The psychiatric nurses are only trained in basic psychiatric nursing and are not well equipped to work effectively with children. Even though psychiatric nurses do not have enough skills and knowledge, it is expected of them to work in child psychiatric wards without adequate knowledge and skills. This creates discomfort to the internal environment of a nurse and the situation can be stressful to the nurse. Psychiatric nursing has two important components which are: supporting people at a reasonable level of functioning which they cannot maintain independently; and facilitating a higher level of functioning in people for whom this is possible. Child psychiatry is one of the specialities in the psychiatric division. ‘The description of the practice of the professional nurse in the field of child psychiatry in South Africa is vague and undeveloped and there are only a few nurses in South Africa with knowledge and skills to set guidelines for this area of practice (Makhele, 2006:36)’. Psychiatric nurses working in psychiatric hospitals undergo different experiences on a daily basis. In this research study, the researcher wondered as to what psychiatric nurses working with children diagnosed with mental illness, experience on a daily basis. The researcher then asks the following questions: 1. What are the lived experiences of psychiatric nurses working with children diagnosed with mental illness? 2. What can be done to assist the psychiatric nurses, working with children diagnosed with mental illness, in order to facilitate their mental health? This research study was done to: 1. To explore and describe the lived experiences of psychiatric nurses, working with children diagnosed with mental illness; and 2. To formulate guidelines in order to facilitate these psychiatric nurses’ mental health. In order to explore and describe the lived experience of psychiatric nurses who work with children diagnosed with mental illness, the researcher used a qualitative design. The researcher utilised phenomenology, in order to explore and describe the experiences of these psychiatric nurses in the context of their working environment. Purposive sampling method was used. In-depth phenomenological interviews were used to collect data. Tesch’s method in Creswell (2011: 113) of open coding was utilised for the analysis of the data. The results were re-contextualised within the literature. The findings of this study provided the detailed content of professional psychiatric nurses’ experience when working with children diagnosed with mental illness. Two themes which were identified are: 1. Theme 1 A challenging experience associated with tensions inherent to the contextual demands of psychiatric nurses working with children diagnosed with mental illness. 2. Theme 2 Psychiatric nurses experience of contextual demands which requires a process of continuous adjustment Guidelines on how to promote the mental health of psychiatric nurses working with children diagnosed with mental illness were derived from the research findings. In conclusion, presently psychiatric nursing training appears to rely upon individual training institutions putting into practice government policy in a fragmented fashion with no cohesive strategy. Where psychiatric nurses receive good quality training which includes child psychiatry, it is clear that good quality and appropriate interventions to children with mental illness and emotional problems can be achieved.

M.Cur. / Violence and aggression in psychiatric hospitals are a worldwide known phenomenon. South Africa is no exception to the rule. Previous researches conducted in psychiatric institutions have mainly focused on the patients, leaving everyone to guess how this violence affects nurses who are in contact with the patients on a daily basis and who are key role-players in the care, treatment, and rehabilitation of the patients under their responsibility. The research aimed to explore and describe the lived experience of aggression and violence by the registered nurses in a Gauteng psychiatric institution, the essence of this violence, and how nurses cope with this violence, in order to formulate guidelines and recommendations that could assist them to manage violence. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews, and naïve sketches. Tesch’s method was used for data analysis, here and an independent coder was utilised. The uniqueness of this study was to bring to the surface the other side of violence as it is perceived and lived by the nurses. The findings show that the nurses face violence on a daily basis. Among the contributing factors there are: the type of patients admitted in the hospital; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation. The consequences of this violence to the nurses are emotional, psychological, and physical and take the form of: fear, anger, frustration, despair, hopelessness and helplessness, substance abuses, absenteeism, retaliation, a development of an “I don’t care attitude”, injuries, and damage to personal properties such as clothes, and spectacles.

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)

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.