Magister Curationis - MCur / Background: Psychiatric nursing in a military setting is aimed at sustaining and facilitating a healthy lifestyle and performance in the achievement of mental health among soldiers. A Registered Nurse (RN) in the military plays a vital role in patient care from time of admission up to discharge. At military hospitals psychiatric nursing personnel are expected to nurse and manage mental ill patients without the help of security guards. This leaves nurses exposed to violence, abuse and psychological distress resulting in poor communication and interaction between RNs and mentally ill patients. Aim and objectives: The aim of this study was to investigate the perceptions of RNs regarding their capability to care for soldiers experiencing mental illness at a military hospital in South Africa. The objectives of the study were to determine the therapeutic commitment, role support and role competency of RNs towards mentally ill patients. Method: A quantitative-descriptive, cross-sectional study design was used in this study. The population is (N=154) RNs of the identified military hospital in South Africa. All the RNs were accessible at 2 Military Hospital and therefore a total enumeration sample was used with (n=117). Statistical Package for the Social Sciences, (SPSS) version 24 was used to analyse data. Findings: The response rate of the study revealed that there is a correlation to gender in relation to therapeutic commitment and role competency. There was a correlation to RNs that had basic psychiatry in relation to therapeutic commitment and role support. The study also indicated there is a correlation to therapeutic commitment, role support and role competency to the period that military RNs worked in Mental Health (MH). There were no trained advanced psychiatric nurses at the military hospital. There were also positive correlations in therapeutic commitment and role competency in the rank of military RNs.

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This study explored Canadian nurse practitioners’ (NPs) levels of therapeutic commitment (TC), role competency (RC) and role support (RS) when caring for persons with mental illness and mental health problems. Knowledge and experiential factors that impact these levels were examined and a model of therapeutic commitment was tested. A self-administered mail survey was sent to 1272 NPs from all Canadian jurisdictions except the Yukon, Saskatchewan and Quebec. The survey was comprised of the Mental Health Problem Perceptions Questionnaire (MHPPQ), demographic data and open-ended questions. Using Dillman’s Tailored Design Method, the target population was contacted 4 times: pre-notice letter, first survey, reminder letter, and repeat survey. Of the 1272 potential participants, 680 (57.2%) useable surveys were received. Out of a possible maximum score of 7, NPs reported mean levels of 5.05 (SD 0.83) on the TC, 5.02 (SD 0.88) on the RC and 4.86 (SD 1.27) on the RS subscales. As hypothesized, correlations between the three subscales were demonstrated with RC and TC being the most strongly associated (r = .754, p <.001). A composite variable, Confidence to Manage, which examined NPs’ confidence to manage 7 mental health disorders and suicide ideation was developed. Scores for this variable correlated with TC, RC and RS scores. Feeling ill-equipped to work with this population, knowledge of community mental health services, ratings of relevant theoretical and clinical NP education, previous mental health and NP work experience were all positively correlated with higher levels of the 4 subscales. Differences in categories for population size of the community the NP worked in, frequency of collaboration for psychiatric reasons, time since the NP accessed mental health education and highest level of nursing education were found to impact levels of TC, RS, RC and Confidence to Manage. A large number of NPs reported feeling inadequately prepared to manage the care of persons with mental illness and recommended either adding or increasing mental health education in their NP programs. Most NPs saw the care of this population as part of their role and acknowledged the need for increased support for persons with mental health issues.