D.Cur. / South Africa, like many other countries, is charged with ensuring that her adolescents are mobilised to believe in the power of their own dignity in order for their life-world to change. Hundreds of thousands of adolescents were forced to experience political upheavals, violence, neglect, incarceration and family disorganisation. Many of these adolescents were forced onto the margins of society in their strive for understanding and survival. Many dropped out of school, are unskilled and therefore unemployed. They feel hopeless as they struggle for a place in society, because society has no faith in them - "they are lost to society". The purpose of this study was to generate a psychiatric nursing model to facilitate the reintegration of marginalised adolescents into the community. This study therefore has profound social, political and economic implications for the South African community. Through this model, which is a theoretical framework to be utilized by the advanced practitioner in psychiatric nursing, adolescents will be empowered to believe in themselves, to engage in meaningful relationships and activities with their families, peer groups and the broader community. The model provides a theoretical framework that attempts to rekindle and inspire the adolescents from a state of hopelessness and disillusionment, to integrated individuals who are respected, valued and accepted as integral members of their families, peer groups and communities. The model will assume a problem solving and preventative approach. Based on this discussion, the following questions were addressed in this research: What obstacles exist that hamper marginalised adolescents' reintegration into the community? What could be done to assist marginalised adolescents' reintegration into the community? A theory generative, qualitative, contextual, exploratory and descriptive design was followed. The research was conducted in four steps with a pilot-study that preceded step one of the research. In step one, focus group discussions were conducted with five groups of respondents to explore and describe obstacles that hamper the reintegration of marginalised adolescents into the community, as well as their views on how marginalised adolescents can be assisted to be reintegrated into the community. Data was analysed using Tesch's method. Based on the results of analyzed data, disempowerment, characterized by hopelessness, alienation/isolation, anger, frustration and worthlessness - related to poor socialisation, lack of support and services, family disorganisation, peer pressure and fragmented services - was identified as a main theme among stumbling blocks. Empowerment, characterized by improved self-image, feelings of worth, belief in own dignity - related to a sense of wellbeing, belonging and respect - resulting in personal growth and societal change with ultimate reintegration, was identified as major strategy to address marginalisation. In step two, the defined concepts were related to each other to show interrelationships. Classification of central and relational concepts followed to formulate relationship-statements, the result being to depict related concepts in structural form. In step three, a visual model to be utilized as a theoretical framework by the advanced psychiatric nurse practitioner to facilitate the marginalised adolescents as recipients and the advanced psychiatric nurse as agent, was designed to facilitate reintegration into the community. The model was evaluated by a panel of experts. Step four dealt with guidelines to operationalise the model in practice, education and research. Recommendations and limitations of the research were also discussed.

D.Cur. / South Africa is currently undergoing radical transformational changes in all facets of its society. This is an era immediately following the first democratic elections in the country. The new Government, the Government of National Unity (GNU) which is dominated by the African National Congress (ANC), has introduced what is known as the Reconstruction and Development Programme (RDP)(ANC, 1994), which seeks to redress disparities of the past. This programme has significant social, political and economical implications for the South African community. It proposes that statutory bodies and institutions should be rationalized and restructured to reflect the diversity of the South African people and should be better able to promote and protect the standards of health care and training. It aims to, inter alia, promote mental health and to increase the accessibility, quality and quantity of mental health support and counselling services. In line with this goal and based on problems that arise because of anxieties and fears that are inherent in change, the mental health of nurse educators and nursing students of a selected nursing college was investigated utilizing a qualitative, theory – generative design which is exploratory, descriptive and contextual in nature. The study was conducted in two phases. In Phase 1, in-depth phenomenological interviews were conducted individually with ten nurse educators and nine nursing students to explore and describe their experience of interaction with one another. Follow-up interviews were also conducted with some of the participants. Data was analysed using Tesch's method. Based on the results of the analysis, the major concept, understanding was identified as the essence of a model for constructive nurse educator - student interaction envisaged. In Phase 2, a theory -generative design was utilized to develop a constructive nurse educator - student interaction model, founded on a mental health approach. The identified concept was examined in existing writings to determine essential criteria of the concept. In addition, a model case was written in which the concept was constructed to the best of the researcher's understanding. Essential criteria of the concept were identified and a concept map was drawn to depict the essential criteria in relation to each other. The related concepts were identified and portrayed in a structural form. The visual model depicts nurse educators and nursing students who function as a family, as the recipients of activity, and the advanced psychiatric nurse practitioner, who facilitates their interaction, as the agent. By utilizing the deductive reasoning strategy, relationship statements were inferred from the model. Guidelines were described for the advanced psychiatric nurse practitioner with regard to all three phases, namely, the Interaction Initiation Phase, the Interaction Cohesiveness Phase and the Interaction Dissolution Phase, in terms of objectives, strategies and proposed activities.

M.Cur. (Psychiatric nursing) / Withdrawal of life-support treatment is a well-known concept which has been studied often, especially from a medical point of view. The life-world of families involved in decision making concerning withdrawal of life-support of a family member is, however, an unknown field. This leads to the reaction and behavior of families to this traumatic process often begin mistakenly described by professionals as "difficult" , "passive" or "incapable of decision making". The patient and his/her family have, to a large extent, the right of self-determination and the right to take part in decision making. In the intensive care unit it often happens, according to Burger (1996:1-175), that the patient is not able to participate actively in the decision making process because of his/her illness and/or medication. The family then steps forward as decision maker and as the patient's "mouthpiece". The situation arises where the family, who must make the decision about withdrawal of life support treatment, are exposed to utterly moral conflict. Burger (1996:163) found that a family that experiences such trauma is not capable of focusing and assimilating knowledge. Members of the family have a great need for support and the intensive care nurse cannot provide that support for different reasons. One of the reasons being limited time and the other not being able to build therapeutic relationships. Because of the above mentioned, the overall objective of this study is to analyse the phenomenon of families who are involved in decision making concerning withdrawal of life-support treatment of a family member. Guidelines have been formulated according to the analysis of this phenomenon for the psychiatric nurse specialist to mobilise resources for the family to promote, maintain and restore their mental health as integral part of health. The research model of Botes (1989:1-283) is used in this study. The study is undertaken from the Judeo-Christian perspective of Nursing for the Whole Person Theory (Oral Roberts University, Anna Vaughn School of Nursing, 1990:136-142). A phenomenon analysis was undertaken in two phases. During the first phase, secondary analysis of primary data was done on the family used in Burger (1996:1-175) and was followed up by phenomenological interviews with families in the same circumstances and according to the same criteria that Burger (1996:1-175) used in her study. Data were analysed in collaboration with an independent coder. The family used for member checking in this study was also used in data control. A literature control was conducted as part of data control. On the ground of the repetitive themes from the secondary analysis and phenomenological interviews with the family involved in member checking, guidelines were formulated in phase two, based on all the data obtained from phase one, for psychiatric nursing specialists to mobilise resources for families in this situation. The proposed guidelines leave the door open for follow-up research where a model for assistance can be formulated for psychiatric nursing specialists to assist these families, since intensive care personnel are either too involved in the process, or do not always know how to build therapeutic relationships and usually also do not have enough time to attend to the patient's family.