M.Cur. / The purpose of this research study was to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. In view of existing problems, such as inadequate preparation of professional nurses for the role of a psychiatric clinical facilitator, inability of student nurses to reflect on their learning and integrating theory into practice, nursing education is faced with a greater need to change from traditional teaching-learning approaches to current student-centred approaches that advocate self-directed learning in student nurses. To achieve this goal in a psychiatric clinical setting, it is necessary to shift the emphasis from instructional teaching to facilitation of reflective learning that results in autonomy and self-reliance in student nurses. Klopper (1994, Monograph 2:24) indicates that the clinical facilitator’s guidance to deep holistic learning is not sufficient on its own. The clinical facilitator should be a reflective practitioner and intentionally facilitate a reflective learning environment for student nurses in a psychiatric clinical setting. The research questions that emerged were: • What is a “reflective learning environment” in a psychiatric clinical setting? • How can a “reflective learning environment” be facilitated for student nurses in a psychiatric clinical setting? To realise the purpose of this research, the following objectives were formulated: • to clarify the concept “reflective learning environment” in a psychiatric clinical setting; • to explore and describe the perceptions of student nurses and clinical facilitators with regard to how a “reflective learning environment” could be facilitated for student nurses in a psychiatric clinical setting; and • to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. The paradigmatic perspective for this research is adopted from the Theory for Health Promotion in Nursing (RAU 2002:4). The functional approach of Botes (1995:13) was used in this study, since it implies application of knowledge. The research design and method used were qualitative, exploratory, descriptive and contextual in nature. The design was divided into two phases. Phase One involved two steps. Step One included the concept analysis of a reflective learning environment through a literature search of all relevant international and national literature on a reflective learning environment. The method of data collection involved a library search – CD-Rom, the Internet, journal articles, books and subject dictionaries - that were used to arrive at attributes that clarified the concept “reflective learning environment” in a psychiatric clinical setting. Concept analysis was done according to the steps described by Wilson (in Walker & Avant, 1983:39). Content analysis of literature was done using deductive, inductive reasoning strategies, synthesis, and inference as described by Chinn & Kramer (1995:63-67), Mouton (1996: 71, 80, 168) and Walker and Avant, (1983:58-62). Theoretical validity was ensured (Mouton, 1996:117). Step Two included the exploration and description of perceptions using agenda focus group interviews held with student nurses and clinical facilitators. The student nurses and clinical facilitators were selected from a psychiatric clinical setting. Both samples were purposively selected. The results of concept clarification conducted gave direction to the agenda focus group interviews that were held with the student nurses and clinical facilitators during the perception survey. The question for the agenda focus group interview with the student nurses was as follows: What are your perceptions with regard to how a reflective learning environment can be facilitated for student nurses in a psychiatric clinical setting? The question for the clinical facilitators was as follows: What are your perceptions with regard to how you can facilitate a reflective learning environment for student nurses in a psychiatric clinical setting? An audiotape was used to record the interviews for later verbatim transcription. Communication techniques, observation and field notes were used during the data collection. Data from both the student nurses and clinical facilitators were analysed according to the qualitative content analysis, as described by Miles and Huberman (1994:241-243). An independent coder, who was purposively selected, was used independently from the researcher in the categorisation of attributes of a “reflective learning environment” that emerged. To ensure trustworthiness in this qualitative research, Lincoln and Guba’s model (1985:290-314) was used throughout the study to ensure the rigor of the study. Ethical considerations were maintained throughout the research study (Denosa, 1998: 1-6; Burns & Grove, 1993:98-104; De Vos, 1998:27-28). Phase Two consisted of conceptualisation of findings from Phase One. Guidelines were formulated based on concluding statements from conceptualisation of the findings. An evaluation of the study was made. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly. The study was conducted contextually and no generalisations should necessarily be made.

M.Cur. (Psychiatric Nursing) / Burnout has severe consequences for the psychiatric nurse as individual and for the mental health delivery system because of an increase in staff turnover and a decrease in the quality of patientcare. Psychiatric nurses suffering from burnout have the potential to experience job satisfaction, if job satisfaction can be facilitated. Job satisfaction of the psychiatric nurse will promote the mental health for her as individual, her patients, colleagues, family and the community. The following aims were set for the research project: Exploring and describing the aspects which cause and promote burnout amongst psychiatric nurses at a private psychiatric hospital; and to formulate guidelines for the psychiatric nursing specialist to facilitate job satisfaction of psychiatric nurses, as an integral part of mental health by means of mobilisation of resources. Nursing for the Whole Person Theory was used as the theoretical framework for this qualitative,contextual study. Botes' Model (1995:4-9) for Nursing Research was used to structure theresearch. The measures which were used to ensure reliability,validity and credibility of the research, were that of Guba (inKrefting, 1991:214-222).A pilot study was conducted to prevent obstacles during gathering and analysis of data. Specific criteria were set for selectionof participants. After conducting a pilot study, fiveparticipants were purposively selected from the target populationat a private psychiatric clinic.Individual focus interviews were recorded on tape and latertranscribed. Data gathering and data analysis were divided in two phases. Three questions were asked during -Phase 1 regarding burnout, and one during - Phase 2- regarding guidelinesfor the prevention of burnout. Data was analyzed systematicallyand descriptive, combining Tesch's (in Creswell, 1994:115) and Kerlinger's (1986:479) methods.

D.Cur. / The goal of this research was to generate and describe a support approach for the advanced practitioner in psychiatric nursing to utilize for the neonatal intensive care nurse, working in a neonatal intensive care unit, in order to promote, to maintain and to restore mental health as integral part of health. Many changes occurred in the health care industry during the twentieth century. In South Africa, health care and social services that have developed, are grossly inefficient and inadequate. The Reconstruction and Development Program (R.D.P.), (1994:42-47), of the government of National Unity, designed therefore a number of programs to restructure the health care services , in order to contribute to the increasing prosperity and quality of life for all South Africans. Free health care has thus to be provided in the public sector for children under six, pregnant and nursing mothers. Free health care makes it more accessible for thousands of people who have avoided seeking help in the past, because of lack of funds. This large influx of patients to health facilities has placed a strain on staff, due to the increased workload. The neonatal intensive care nurses' workload and responsibilities have thus increased.

M.Cur. / The increasing use of intoxicating substances worldwide has made societies shift deeper into the culture of substance abuse. The situation in South Africa is likely to be the same. Unfortunately, the scourge of substance abuse affects family life by causing family disruptions which lead to various social pathologies of our time. There is considerable literature supporting the stressful life experienced by adolescents living in neglectful, violent, conflict- and fight-orientated environments caused by the abuse of substances by parents. This study was carried out for the purpose of investigating the life-world of adolescents living in substance-influenced homes. The study is qualitative, explorative, descriptive and contextual in approach and it, therefore, became necessary to use phenomenological semi-structured interviews with the adolescents whose parents abuse substances. The sample consisted of eight high school adolescents living in three rural villages of Lomayaneng, Motsoseng and Seweding in Mafikeng. Before the interview, trust was built through written permission to the principals of the schools concerned and the parents of these children to conduct the research. At the same time, the adolescents were informed of what the research concerns before the main interview. Data was analysed utilizing Giorgi's and Tesch's methods. Trustworthiness was, amongst others, ensured throughout the study by applying Guba's approach, including the services of an independent coder. The findings of the study indicated that adolescents whose parents abuse substances live a stressful life and suffer much shame, neglect, despair and trauma because their aspirations, for example, education, emotional/spiritual, physical and social, are frustrated since their home life is dysfunctional. Two main themes were identified: Disrupted family life related to abuse of substances and stressful life related to frustrated aspirations; and their consequences were found to be that these adolescents use ineffective coping mechanisms, for example over-responsibility for all family members and failure to seek professional help with a view to coer the defects in their families. Guidelines for psychiatric nurses were built around these themes with the aim of assisting adolescents who are faced with similar situations to promote, maintain and restore their mental health as an integral part of health.

D.Cur. / The impressive growth in the extent and range of psychiatric services provided by general hospitals in South Africa, creates stress among nurses employed in these settings which manifests its self in the negative attitudes displayed towards mentally ill people, refusal of dual diagnosis patients transferred from medical surgical units and poor intra-institutional relationships between nurses in medical-surgical units and those who are in the psychiatric unit. This has led to the research study aimed at describing a model for support to assist general hospital nurses mobilize appropriate resources in the process of nursing mentally ill people. The research methodology followed the research model in nursing proposed by Botes (1995). A theory generative, qualitative, explorative, descriptive and contextual design was followed. The research methods were dealt with in four steps of theory generation in the following manner: Step 1: Concept analysis: This step was dealt with in two phases which are concept identification and concept definition. During concept identification, a qualitative research strategy which is explorative, descriptive and contextual was used. This was attained through field research conducted in an urban general hospital. A sample of twelve professional was selected from a population of 800 professional nurses employed in a general hospital using a purposive sampling technique. This sample size was determined by saturation of data in themes. Both semi-structured individual phenomenological interviews and observations were used as methods of data collection. The field work was conducted without any preset theoretical framework of reference by using "bracketing" and "intuiting". Giorgi's (1986) method of descriptive data analysis was used. After data analysis, the results were reflected within the Nursing for the Whole Person Theory. Four themes emerged from the results of the study which were:1) the experience with the perception of the mentally ill people, 2) the experience with interpersonal communication patterns, 3) nurses' experience of violence and lastly, 4) the experience of inappropriate patient behaviours. It became clear that the experience of nursing mentally ill people was negative and affected the social, psychological and the physical dimensions of nurses. The results were validated through literature control. The major concept of model was identified as "facilitation of communication". The concept was analysed thoroughly by looking at the dictionary and subject usage. The defining attributes were identified and synthesised through a definition. The other related concepts were identified and classified using a survey list of Dickoff, James & Wiedenbach (1968:430). Step 2: Step 2 dealt with the creation of interrelationship statements between concepts identified in step 1, so that concepts were able to stand in relation to one another. Step 3: dealt with the description of the model using strategies proposed Chin & Kramer (1991). Step 4: dealt with the description of guidelines for model operationalization in practice, education and research. The evaluation of model operationalization will be carried out in future research. To ensure valid results, a model trustworthiness proposed by Guba (Lincoln & Guba, 1985) was used. The following criteria for trustworthiness was applied in all the steps of theory generation: truth value, applicability, consistency and neutrality.

M.Cur. (Psychiatric Nursing) / A diagnosis of cancer causes certain fears to arise in a patient, as well as among his family, activating intense emotional responses in everyone concerned. Examples of such emotions are anger. self-reproach, gUilt, heartache, helplessness and mourning. An acceptance of the circumstances does not necessarily occur, and the phases of the mourning process may be continually interchanging. As a result of all these emotions experienced by the patient with cancer as well as his family, mental discomfort is likely to occur. The family has to adapt its usual mechanism for handling internal discomfort, in order to include the pressure and demands to which they will be exposed as a result of the cancer and treatment thereof. Family cohesion will not necessarily be advanced as a result of this heightened pressure, and additional pressure may be placed on relationships within the family. Members of a family often find it difficult to discuss openly their fears, worries and feelings. for the simple reason that they are scared of becoming upset themselves, or alternately upsetting the rest of the family. Holding themselves back in this way may lead to a feeling of being isolated, which in turn leads to feelings of uncertainty being experienced. In this way the members of a family may find themselves becoming less and less involved with each other and with the patient's treatment, all as a result of not being able to talk about their fears and other intense emotions and therefore not being able to realise all these feelings. As a result of the family's uncertainty concerning their handling of the situation, they experience a loss of control and a change in their ability to handle their situation. These factors contribute to their experience of mental discomfort. Mental discomfort is not visible to others, therefore it is very rarely treated by the multiprofessional team. If the members of the team notice the existence of such discomfort, they will still emphasise the medical treatment, since they themselves may be uncertain as to any effective treatment for such a family. The registered nurse who is in continuous contact with the patient and his family, therefore has the challenge to support the family who suffers from mental discomfort in order to lessen their suffering and facilitate their striving towards achieving wholeness once more, whether in hospital, at home or in a community centre. There are several methods of interaction available for the treatment of such a family. Mental discomfort can be reduced by psychiatric nursing accompaniment. The purpose of this study was to explore and describe the folloWing: the contribution made by psychiatric nursing accompaniment through the medium of a psychiatric nursing specialist, as regards lessening the mental discomfort of the family of a patient being treated in an oncology unit or at home. A further purpose was to set certain guidelines for the registered nurse, concerning her support of the family of a patient in an oncology unit or at home, thereby lessening their mental discomfort. An exploratory, descriptive, contextual study was done on a family with one member who has been diagnosed with cancer, and who received treatment in an oncological unit and at home. This family submitted themselves to psychiatric nursing accompaniment. A purposive, non-selective sample was used and the family had to satisfy certain specific criteria pertaining to mental discomfort...

M.Cur. (Psychiatric Nursing) / The objectives of this study were to describe group nursing therapy as a resource utilized by the psychiatric nurse as a way of facilitating the adolescent's mobilization of resources to cope with the violence in their everyday life and to describe guidelines for group nursing therapy to facilitate the promotion, maintenance and restoration of these adolescent's mental health. The situation of violence makes the adolescent susceptible to mental health problems. The adolescent perceive various degrees of violence in their homes, the community and at school. A combination of these violence related situations predisposes the adolescents to developing unhealthy ways of coping with the effects of violence. The number of adolescents referred to psychiatric community services has increased at an alarming rate. The main reasons for their referral was their poor scholastic performance; they were generally labelled as "a lost generation" and also as being mentally ill. The research was based on Nursing for the Whole Person Theory and the functional approach to nursing research was assumed. This implies that the goal of the research was aimed at improving the quality of patient care. The research design was descriptive and qualitative in nature, which was also contextual. The descriptive single case study method was utilized. Reliability was ensured by using as many steps as possible to operationalize the case study - and the research was conducted as if someone were always looking over the researcher's shoulder. Validity control measures were applied to counteract criticism by ensuring that a sufficient operational set of measures was developed and objective judgements were used to collect data by way of coding transcribed audiotaped material from all the sessions of the group nursing therapy...

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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.

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