D.Cur. / The occupation of the SOS mother, which involves long-term care for orphaned and abandoned children under the SOS Children's Villages organisation, is unique and peculiar in many respects. She is expected to play a dual role of being a foster parent and a childcare professional, at the same time. The latter presents challenges of its own because the professional status is only recognised internally by the organisation. In one way or another, most of the children for which the SOS mother is responsible, have been exposed to some form of trauma. The problems of caring and parenting such children are well documented in the literature. These include learning and behaviour problems. For this reason, the mental health of the SOS mother, who is the focus of this study, should be of special interest to mental health practitioner. The motivation for this study arises out of a change that the organisation is trying to enforce in the work of the SOS mother. This change comes with the release of the new quality standards to guide village work. One of these standards, the SOS mother's autonomy, requires the SOS mother, like any mother in the community to take full responsibility for her SOS family, including the development of the children under her care. When she needs help, she seeks expert advice from village co-workers and from the community. In addition, the career of the SOS mother has to be developed so that she functions like a childcare professional and that her training is recognised by the government and other training institutions. This represents a big change from how most SOS villages have been operating. Up to this point, village co-workers made important decisions about the SOS family and the children while the SOS mother did the caring part. The change is expected to affect the interactions between SOS mothers and their co-workers and consequently, their mental health. For this reason, it was felt that there was a need to facilitate the implementation of the SOS mother's autonomy standard, which would also promote the mental health of the SOS mothers. The purpose of this research was, therefore, to develop and describe a model that would serve as a framework for the advanced psychiatric nurse practitioner to promote the mental health of SOS mothers by facilitating the implementation of the SOS mother's autonomy within SOS Children's Villages of Southern Africa Region 11. The research also focused on developing guidelines for the implementation of the model in practice.

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Workplace violence directed at student nurses in training in psychiatric institutions is a significant concern as it negatively affects the quality of learning and causes the students to have a negative perception of nursing as a profession. The absence of scientific data describing the perceptions of student nurses about workplace violence and their clinical learning outcome motivated the researcher to conduct the study. Quantitative, descriptive research was conducted to explore the influence that workplace violence will have on clinical learning outcomes of student nurses who are studying psychiatric nursing at psychiatric institutions in KwaZulu-Natal, in South Africa. Data was gathered using a 71 question questionnaire, which was adapted from the one used by Hewett (2010). With the necessary permission from the health authorities, the campus principals and the nursing students, a group of 4th year student nurses (n=163) from 6 campuses of the KwaZulu-Natal College of Nursing (KZNCN) who have worked in psychiatric units for at least 3 months and longer participated in the study. The study highlighted the types of workplace violence encountered by student nurses, the effects of workplace violence on students’ academic performance and the barriers to the reporting of workplace violence encountered by the student nurses. The study revealed that there is a large amount of non-physical, some physical and a few incidents of sexual violence directed towards the student nurses at the psychiatric institutions, and that it has a negative impact on student learning. The recommendations emanating from the study support the idea of a shared responsibility between healthcare and education institutions and the focus is on preparing and equipping the student psychiatric nurses to confront, withstand and break the cycle of workplace violence. / Health Studies / M.A. (Nursing Science)

The purpose of the study was to explore and describe the lived experiences of general nurses working at Standerton hospital medical wards which also admit psychiatric patients. A qualitative, descriptive phenomenological approach was used for the study. The study population consisted of seven general nurses working in medical wards at Standerton hospital. Purposive sampling was used to select participants who met the inclusion criteria. Researcher used in-depth face to face interviews to collect data until data saturation was achieved. Tesch’s method of qualitative data analysis was utilised to identify themes. Three themes and five sub-themes emerged from the study: theme1: perceived danger due to aggression sub-themes stress for medical patients, stress for medical patients’ families and stress for nurses. Theme 2: lack of skills in dealing with psychiatric patients’ sub- theme use of restrains. Theme 3: self fulfilling prophecy subtheme reported incidences. The study findings demonstrate the plight of general nurses who are not trained to work with psychiatric patients but continue to do so. Findings further accentuate what is already known about the labelling that goes with psychiatric patients and aggression as a resultant effect. Recommendations were made for future research, policy makers, nursing education and practice. / Health Studies / M.A. (Health Studies)

Text in English / The purpose of the study was to describe and explore the experiences of student nurses in caring for mental health users with profound intellectual disabilities in one of the care and rehabilitation centre at Gauteng province incorporating the Common Sense Model. Qualitative descriptive and explorative research was conducted to explore the experiences of student caring for mental health care users with profound intellectual disabilities and to recommend the best practices in caring for mental health care users with profound intellectual disabilities. Data collection was done using reflective diaries and in depth interviews. Twelve participants participated in the study. The study composed of student nurses (n=12) caring for mental health care users with profound intellectual disabilities. Five themes emerged from the study i.e. emotionally challenging, communication difficulties, lack of knowledge on the nature of intellectual disability, burden of care and mixed feelings. Findings of the study revealed that completing nurses find working with profound intellectual disabilities to be emotionally challenging and that negative experiences outweigh the positive experiences, resulting in their reluctance to want to work with profound intellectual disability users. It is therefore incumbent upon policy makers and hospital administrators to take cognisance of these negative feelings so that ways of minimising these frustrations and promoting the wellbeing of nurses caring for mental health care users with profound intellectual disabilities are promoted. / Health Studies / M.A. (Health Studies)

Text in English / The purpose of the study was to describe and explore the experiences of student nurses in caring for mental health users with profound intellectual disabilities in one of the care and rehabilitation centre at Gauteng province incorporating the Common Sense Model. Qualitative descriptive and explorative research was conducted to explore the experiences of student caring for mental health care users with profound intellectual disabilities and to recommend the best practices in caring for mental health care users with profound intellectual disabilities. Data collection was done using reflective diaries and in depth interviews. Twelve participants participated in the study. The study composed of student nurses (n=12) caring for mental health care users with profound intellectual disabilities. Five themes emerged from the study i.e. emotionally challenging, communication difficulties, lack of knowledge on the nature of intellectual disability, burden of care and mixed feelings. Findings of the study revealed that completing nurses find working with profound intellectual disabilities to be emotionally challenging and that negative experiences outweigh the positive experiences, resulting in their reluctance to want to work with profound intellectual disability users. It is therefore incumbent upon policy makers and hospital administrators to take cognisance of these negative feelings so that ways of minimising these frustrations and promoting the wellbeing of nurses caring for mental health care users with profound intellectual disabilities are promoted. / Health Studies / M.A. (Health Studies)

The aim of this study was to determine the ability and proficiency of the newly qualified professional nurses in utilising psychiatric nursing skills at Chris Hani District Psychiatric Health Care Services in the Eastern Cape, South Africa. The research method was a qualitative, phenomenological approach. A purposive sample of newly qualified professional nurses and supervisors participated in the study. The data were collected through interviews and focus group discussions, using semi – structured interview guides. Interviews responses were recorded on the interview guide. Data were analysed using the computer software Atlas ti and manually. Positive and negative themes were identified. Ethical considerations were ensured by means of privacy, anonymity and confidentiality. Ethical clearance was obtained from the University of Fort Hare and permission from the Provincial Department of Health and Chris Hani District Health and Mental Health Institution at Queenstown was sought. The findings revealed that newly qualified professional nurses performed well, according to the perception of their supervisors. Newly qualified professional nurses were faced with challenges such as shortage of resources, mental illness not considered as a priority and lack of skills development. The study also revealed that newly qualified professional nurses focussed on the curative aspect of ailments, rather than preventive care. However community health workers (CHW) focussed on the preventive aspect of care. Limitations and recommendations based on the findings of the study are presented.

PhD (Nursing Science) / Department of Advanced Nursing Science / State patients are admitted to the psychiatric hospital after being declared as such by a court of law in South Africa. After successful rehabilitation of state patients at the psychiatric hospital, they need to be reintegrated into their families. Perceptions of family members of male state patients regarding reintegration including development of a model to support such reintegration, is not largely explored in the scientific body of knowledge. The aim of this study was to develop a model to support reintegration of state patients into their families in Limpopo Province, South Africa. A qualitative approach using descriptive, explorative, and contextual designs was adopted for this study. The study population was family members whose relatives are male state patients admitted and recorded in the admission register of Hayani Hospital, in Limpopo Province. The study was conducted in two phases of which phase one was a situational analysis, and phase two was the development of the model to reintegrate male state patients into their families. This study was conceptualized within the Social Ecological Model (SEM) of human behaviour (Stokols, 2013), the grounded theory for model development outlined in Dickoff et al. (1968), and the approaches outlined in Chinn and Kramer (2008); Walker and Avant (1995). Model evaluation was done by a group of health professionals, some of whom are advanced psychiatric nurses who are doing masters and doctoral studies, and one doctoral graduate who is also an advanced psychiatric nurse. Presentations were made to this group during peer review sessions who in turn gave critical comments regarding the developed model to support reintegration of male state patients until the final model was accepted. Non-probability purposive and convenient sampling were used to sample a hospital and 10 family members of Venda-speaking male state patients. In-depth individual interviews were used as the instrument to collect data which was pretested on one family member who did not form part of the study. Data was analysed using thematic analysis approach. Data was co-coded by an independent doctoral degree graduate to ensure trustworthiness. Conducting home visits by health professionals came up strongly during data analysis. Credibility, dependability, confirmability and transferability to ensure trustworthiness of the study, as well as ethical considerations were adhered to. The findings of the study yielded two themes, being perceptions of participants regarding reintegration of male state patients, and perceptions of participants regarding the support needed from family members to reintegrate male state patients. During phase one, the results indicated that family members accept reintegration and also that they indicated the kind of support needed, that lead to phase two of developing a model to reintegrate male state patients. The study was restricted to only one hospital in the Vhembe District out of the five districts of the Limpopo Province.The researcher acknowledges that this study was contextual and that only family members of male state patients were interviewed, the perceptions of family members of female state patients were not heard. The study concluded that there are perceptions that family members of male state patients have regarding reintegration of these patients into their families. Furthermore, family members of male state patients can describe the kind of support that they need in order to reintegrate male state patients into their families. This should be done using the developed model that should involve family members and the community. The study recommends that psychiatric hospitals should implement the model involving family members of male state patients. Furthermore, a longitudinal study should be conducted for a period of 3-5 years to check the effectiveness of the model. / NRF

The purpose of the study was to explore the understanding and implementation of the guidelines by nurses to detect mental disorders in Human Immunodeficiency Virus (HIV) management in the Limpopo Province, South Africa. The study aimed to recommend measures to strengthen implementation practices. Qualitative, exploratory and descriptive approach was conducted. Non-probability purposive sampling was used to select primary health professional nurses trained in HIV programme at primary health care facilities in Capricorn District. Data were collected through focus groups and in-depth individual interviews approach using the interview guide. The interviews started with focus group discussions as primary method and in-depth individual interviews as follow-up. Interviews were tape recorded and transcribed. Data were analysed using Creswell’s data analysis steps. Four themes emerged from data: understanding of HIV management guidelines; implementation of the guidelines; strengthening of mental health screening and competencies required for mental health screening. The study revealed that the nurses who did not have psychiatric nursing as an additional qualification lacked confidence and skills to conduct mental health screening in HIV positive infected individuals. However, they used their background nursing knowledge to manage clients. They all experienced challenges with information provided in the guidelines to screen for mental health in HIV management. Based on the results of this study, it was recommended that there should be integration of mental health and HIV and development of practical assessment tools for mental health screening. The study acknowledges the importance of equipping nurses with adequate skills to diagnose altered mental health states among HIV infected individuals. / Health Studies / M.A. (Nursing Science)

MCur / Departrment of Advanced Nursing Science / In mental health, a Maximum-Security Ward is a special setting for care of patients who are unique and exceptional. People who have committed crimes due to their mental conditions are admitted for care, treatment and rehabilitation. Patients admitted in this ward are verbally and physically aggressive, violent, unpredictable, unmanageable and at times manipulative. Professional nurses working in the Maximum-Security Ward are at risk of suffering from occupational stress, burnout, lack motivation and are anxious. The aim of this study is to investigate the experiences of professional nurses working in the Maximum-Security Ward at Hayani hospital. A qualitative approach using a descriptive, exploratory and contextual design was used. A purposive, convenient sampling was used to sample professional nurses working in the Maximum-Security Ward of Hayani hospital. In-depth interviews were used to collect data. A voice recorder was utilised to record all data and the researcher being the main instrument for data collection. Dependability, confirmability and transferability were upheld to ensure trustworthiness of the findings. Data was analysed using Tech’s eight steps approach. Three themes with their categories and subcategories emerged after data analysis. The themes were as follows: the participants’ views on type of patients admitted in the ward, participants’ views on safety in the ward and participants’ views on staff interaction. The study recommended the following: Emotional counselling and debriefing sessions to be conducted at regular intervals or after a traumatic incident. Motivational and team building activities to be organised for professional nurses. Safety of professional nurses must be of significant value. More support is needed in times of emotional difficulties. Development of a model to support professional nurses. / NRF