Due to the global push for deinstitutionalisation, the care of psychiatric patients has been transferred to their family members. Evidence worldwide however suggests that the rate of deinstitutionalisation has not been matched with the sufficient increase of community resources to support both the caregiver and the patient in the community where they reside (Lippi, 2016:1). The conducted study undertook to explore and describe the experiences of caregivers of Mental Health Care Users (MHCUs) with a diagnosis of Schizophrenia in the southern- western parts of Johannesburg. The goal of the present study was to explore the experiences of the caregivers of MHCUs with schizophrenia in the southern- western parts of Johannesburg. A qualitative research approach was utilised to conduct the study. The researcher made use of purposive sampling and semi-structured, face to face interviews were utilised to collect data. Ten interviews were conducted with caregivers of MHCUs in Lenasia South. The researcher however reports on 9 of the 10 interviews due to the fact that the recording device was stolen in the home of the researcher before the recording could be backed up. The findings of the study indicate that the caregivers of MHCUs often do not know the name of the diagnosis and do not understand the diagnosis. Many of the caregivers held the belief that the MHCU was bewitched. The social lives, health and finances of caregivers were negatively affected by the task of caregiving. The study found that caregivers are reluctant to leave the MHCU alone or in the care of other people, because they are constantly worried about their well-being. The study found that caregivers were stigmatised together with the MHCU in their communities. Community resources to support the caregiver and provide psychoeducation are non-existent in the experience of these caregivers. The study found that caregivers had minimal to no experience at all of receiving support from a social worker. The study concludes that the experiences of caregivers are difficult because of the lack of understanding of the illness, a lack of support and psycho-education and a lack of community resources that can aid the caregiver. Recommendations in the study include making a referral to be seen by a social worker mandatory for each case, social workers facilitating the start-up of peer support groups for the caregivers and being intentional about psycho-educating caregivers. / Mini Dissertation (MSW)--University of Pretoria, 2019. / Social Work and Criminology / MSW / Unrestricted

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

<p>Syftet med denna studie var att analysera skriftligt arbetsmaterial och offentliga informationsdokument som ligger till grund för förändringsarbete för ett ökat brukarinflytande gällande sociala omsorgsinsatser och servicetjänster i ordinärt boende, det vill säga det egna hemmet. Vi valde att studera Örebro kommun och detta genom en kvalitativ metod i form av en litteraturgranskning. Vårt teoretiska fundament har bestått av socialtjänstlagen, Lag om kommunal befogenhet att tillhandahålla servicetjänster åt äldre, Lag om valfrihetssystem, salutogent synsätt, Kasam och empowerment. Vårt resultat visar att Örebro kommun har infört fyra medel för ett ökat brukarinflytande. Dessa är: förändrad biståndshandläggning, Lag om kommunal befogenhet att tillhandahålla servicetjänster åt äldre, Servicetorget med lotsarna samt Lag om valfrihetssystem. Vi har även studerat hur Örebro kommun har valt att tillämpa Lag om valfrihetssystem med utgångspunkt från lagstiftarens intentioner. De slutsatser vi kan dra från vår studie är att Örebro kommuns ambition är att uppnå ett ökat brukarinflytande för de äldre. Dock ser vi att det är de äldre som har kunskap, kraft och ork att föra sin talan, som kommer att kunna åtnjuta brukarinflytande. De äldre som inte besitter dessa egenskaper kommer dock att behöva ett mer omfattande stöd och hjälp från kommunen för att uppnå ökat brukarinflytande.</p> / <p>The purpose of this study was to analyze the written working material and public information documents on the basis of change for increased user involvement in terms of social care interventions and services in ordinary housing. We chose to study Örebro municipality and this through a qualitative approach in the form of a literature review. Our theoretical foundation consisted of the Social Services Act, Act on municipal authority to provide services to the elderly, the Act on freedom of choice system, salutogenic approach, Kasam and empowerment. Our results show that Örebro municipality has introduced four measures for enhanced user involvement. These are: change needs assessment, Act on municipal authority to provide services to older, the Service market with guides and the Act on freedom of choice system. We have also studied how Örebro municipality has chosen to apply the Act of freedom of choice system based on the legislator’s intentions. The conclusions we can draw from our study is that Örebro municipality has the ambition to achieve a greater user involvement of the elderly who have knowledge, power and energy to present the case. The elderly who do not possess these characteristics will need more extensive support and assistance from the municipality to achieve increased user involvement.</p>

Syftet med denna studie var att analysera skriftligt arbetsmaterial och offentliga informationsdokument som ligger till grund för förändringsarbete för ett ökat brukarinflytande gällande sociala omsorgsinsatser och servicetjänster i ordinärt boende, det vill säga det egna hemmet. Vi valde att studera Örebro kommun och detta genom en kvalitativ metod i form av en litteraturgranskning. Vårt teoretiska fundament har bestått av socialtjänstlagen, Lag om kommunal befogenhet att tillhandahålla servicetjänster åt äldre, Lag om valfrihetssystem, salutogent synsätt, Kasam och empowerment. Vårt resultat visar att Örebro kommun har infört fyra medel för ett ökat brukarinflytande. Dessa är: förändrad biståndshandläggning, Lag om kommunal befogenhet att tillhandahålla servicetjänster åt äldre, Servicetorget med lotsarna samt Lag om valfrihetssystem. Vi har även studerat hur Örebro kommun har valt att tillämpa Lag om valfrihetssystem med utgångspunkt från lagstiftarens intentioner. De slutsatser vi kan dra från vår studie är att Örebro kommuns ambition är att uppnå ett ökat brukarinflytande för de äldre. Dock ser vi att det är de äldre som har kunskap, kraft och ork att föra sin talan, som kommer att kunna åtnjuta brukarinflytande. De äldre som inte besitter dessa egenskaper kommer dock att behöva ett mer omfattande stöd och hjälp från kommunen för att uppnå ökat brukarinflytande. / The purpose of this study was to analyze the written working material and public information documents on the basis of change for increased user involvement in terms of social care interventions and services in ordinary housing. We chose to study Örebro municipality and this through a qualitative approach in the form of a literature review. Our theoretical foundation consisted of the Social Services Act, Act on municipal authority to provide services to the elderly, the Act on freedom of choice system, salutogenic approach, Kasam and empowerment. Our results show that Örebro municipality has introduced four measures for enhanced user involvement. These are: change needs assessment, Act on municipal authority to provide services to older, the Service market with guides and the Act on freedom of choice system. We have also studied how Örebro municipality has chosen to apply the Act of freedom of choice system based on the legislator’s intentions. The conclusions we can draw from our study is that Örebro municipality has the ambition to achieve a greater user involvement of the elderly who have knowledge, power and energy to present the case. The elderly who do not possess these characteristics will need more extensive support and assistance from the municipality to achieve increased user involvement.

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

Thesis (M. Cur.) --University of Limpopo, 2015 / Background: Re-admission is a common problem encountered in psychiatric care. Re-admissions are often, but not always, related to a problem inadequately resolved in the prior hospitalization. A better understanding of factors leading multiple psychiatric admissions is needed. Such knowledge can help planners to set priorities and to make appropriate services and resources available to mental health care users and their families after hospital discharge. Objective: The purpose of this study was to explore the factors leading to re-admission of mental health care users at the Thabamoopo Psychiatric Hospital, Limpopo Province. Methodology: A qualitative phenomenological research approach was used to explore the factors leading to readmission of mental health care users. Purposive sampling was used to select participants of the study at the Thabamoopo Hospital. Twelve one-on-one semi-structured interviews were conducted. Ethical clearance was granted by the Medunsa Research Ethics Committee and permission to collect data was granted by the Limpopo Department of Health. The data were analysed through Tesch’s method of analysis. Results: The research findings indicate that the use of substances, non-adherence to psychiatric medication, the nature of the illness and social problems contributes to readmission of mental health care users. Conclusion and recommendations: In order to deal with factors related to re-admission of mental health care users, the mental health care practitioners, mental health care users and their families must be involved and work together.

MCur / Department of Advanced Nursing Science / Background- Family support is the most important milieu for the treatment and rehabilitation for mental health care users. However, there are cases that are reported where mental health care users are rejected by their family members worldwide. Vhembe District is no exception. Purpose-The study determined factors affecting family members’ support of their state patients in Hayani hospital, Vhembe District, Limpopo Province. Methodology- The study adopted a qualitative design which was explorative, descriptive and contextual in nature. Non-probability purposive sampling method was used to sample 09 family members with state patients at Hayani Hospital from the entire population. Data was collected through in-depth individual interviews and analysed through Techs method of coding. Ethical considerations and measures to ensure trustworthiness were followed throughout the study. Results- Data revealed two themes from namely, psychological factors and sociological factors affecting family members’ support. Recommendations- This study recommends on developing a model of support for family members’ with state patients at Hayani hospital. This study also recommends that department of health should consider meetings with family members. / NRF

Magister Curationis - MCur / Psychiatric nurses are known for their person-centred care approach that offers help through a therapeutic communication approach. In South African nursing, a Professional Nurse is a nurse whose role include but not limited to conducting a comprehensive and holistic health assessment on clients of all age groups, with complex health problems, determines the health needs of the community, early detection, diagnosis, treatment and appropriate referral to higher levels of care.

Care transition, the process of moving from community care to residential care, is one of the biggest changes that older people can experience in their later life. Evidence from the literature suggests that older people's experiences of care transition tend to be negative and traumatic, with most of them being little involved in the process of care transition. How older people exercise choice during the period of care transition is important for understanding their experiences of care transition for the following two reasons: first, choice has been referred to in the literature as the key to less stressful care transition experiences, which can subsequently lead to a better quality of life in residential homes; second, the introduction of choice in public services has been the key plank of British social policy in recent decades and there has been a movement towards extending choice in residential care. This research aims to study older people's care transition experiences and their exercise of choice during the process of care transition, to explore the meaning and the perceived effects of choice and to identify the role of choice in promoting a positive care transition. This thesis presents findings from 48 in-depth interviews with older people who became new residents in one of the ten participating residential homes in London and had their care paid for by the local authority. This research identified four groups of older people who showed marked differences in terms of their needs, their exercise of choice during the care transition process and their adaptation to residential care: Active Planners, Conformists, the Unsettled and Shelter-Seekers. The findings from this research suggest that the older people's care transition experiences varied and that they stretch beyond the prevailing evidence emphasising the stressfulness of the care transition. The cases of Active Planners and Shelter-Seekers show the potential for positive roles for care homes in the case of users with genuine needs for residential care. An overwhelming majority of the older people who were interviewed were great proponents of choice and many of them actively exercised choice in the course of their care transition. This challenges the claim of the passivity of older people which has been argued in the literature. However, the cases of some Conformists who did not want to exercise choice also highlight that having no choice can be a choice for some older people. On the whole, older people’s exercise of choice played an important role in facilitating a positive transition, despite it not being a precondition for such a transition. However, there were administrative issues limiting the level and the extent of choice that were available to the older people and the Unsettled experienced an undesired move into a care home, having their choices denied or rejected. This thesis also questions the working of choice and competition in residential care, as the older people did not seem to enjoy the expected benefits of choice relating to service improvements which have been argued for in the literature.

PHDPH / Department of Public Health / Family involvement in caring for mentally ill patients in long-term mental healthcare institutions is defined as a strategy in which family members and long-term healthcare professionals become partners to provide the best possible care for a person with mental illness. The study seeks to develop a model to promote family involvement in long-term mental health care institutions in Limpopo Province, South Africa. Mixed methods was used. Unstructured interviews were conducted with 21 family members and 6 focused group discussions with MHCUs in qualitative phase. Self-administered questionnaires were used to collect data from 360 nurses in the quantitative phase. Data was analysed independently of which convergent analytic approach was used to merge the two data sets. iv The study reports that the MHCUs’ attitudes towards families contribute to poor involvement by family members in the care/visit of the MHCUs while admitted in long-term mental health care. The rejection of the MHCUs also came up strongly during data analysis. Nurses perceived that insufficient family involvement hinders the provision of mental health care services. Eight steps in the Walker and Avant Method were adapted to clarify and distinguish the definition of the main concepts. A model to promote family involvement was conceptualised using the six areas as described by Dickoff, James and Wiedenbach (1968). A model was validated against its rationale and purpose of the study. Justification on the contribution of the family involvement in mental health care revealed that “family involvement in caring for MHCUs” is an engagement and encourages family members to participate in the diagnosis, treatment and recovery process. Study recommended that a developed model should be implemented in health establishments providing mental health services. Policies should be reviewed to include activities which the families should be notified of immediately the mentally ill patient is declared to receive mental health care, treatment and rehabilitation. Developed model should be piloted and evaluated to identify areas that will further improve the quality of mental health services. / NRF