The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and families, no study to date had looked at MI from the perspective of the child. Thorne’s (2008) framework for interpretive descriptive research was used for this study. Individual interviews with children ages 7 through 13 were conducted in an outpatient weight management clinic that utilizes MI as the primary communication style for facilitating behavior change. Qualitative data analysis was conducted utilizing Thorne’s recommendations for interpretive descriptive research. Five themes emerged from the data: 1) Empowerment, 2) Freedom to be Me, 3) Educating without “Educating”, 4) Unconditional Support, and 5) Blossoming. A conceptual model was developed from the research findings to help clinicians working with children in similar contexts glean a deeper understanding of the use of MI with children. Future research endeavors should focus on the implementation of this model in clinical practice to strengthen the conceptual links and determine applicability to practice.

This thesis attempted to examine stressors associated with the psychiatric technician profession and levels of burnout amongst them. This was accomplished through the use of a survey which included demographic data, the Maslach Burnout Inventory Human Services Survey (MBI‑HSS), an adaptation of the Nursing Stress Scale (NSS) and a self‑care assessment tool. A total of three research questions were examined statistically including levels of burnout on subcategories (personal accomplishment, emotional exhaustion and depersonalization), most common stressors identified by psychiatric technicians and percentage of participants who utilized therapy to cope with work related stress. The survey was made available via survey monkey and posted on the website for the California Association of Psychiatric Technicians website and via links posted on Union Chapter social media pages. A total of 123 Psychiatric Technicians participated in the study. Results indicated high levels of emotional exhaustion, depersonalization and personal accomplishment among psychiatric technicians. Results indicate that extended work hours and staffing minimums were significant issues impacting union members. Also significant among participants, was high level of difficulty attending work due to work related stress during the last three months. For future research, it is recommended that similar studies of psychiatric technicians be conducted to provide further insight into burnout, how it happens and how to avoid it.

Interpersonal violence and abuse in New Zealand is so widespread it is considered a normative experience. Mental health nurses witnessing the inscribed effects of abuse on service users are lead to consider whether we are dealing with a breakdown of the mind or a breakdown in social or cultural connection (Stuhlmiller, 2003). The purpose of this research is to examine the cultural context which makes violence and abuse against women and children possible. In 2003, the public debate on prostitution law reform promised to open a space in which discourses on sexuality and violence, practices usually private or hidden, would publicly emerge. Everyday discourses relating to prostitution law reform reported in the New Zealand Herald newspaper in the year 2003 were analysed using Foucauldian and feminist post-structural methodological approaches. Foucauldian discourse analysis emphasises the ways in which power is enmeshed in discourse, enabling power relations and hegemonic practices to be made visible. The research aims were to develop a complex, comprehensive analysis of the media discourses, to examine the construction of harm in the media debate, to examine the ways in which the cultural hegemony of dominant groups was secured and contested and to consider the role of mental health nurses as agents of emancipatory political change. Mental health promotion is mainly a socio-political practice and the findings suggest that mental health nurses could reconsider their professional role, to participate politically as social activists, challenging the social order thereby reducing the human suffering which interpersonal violence and abuse carries in its wake.

Aim To describe psychiatric nursing students‟ stereotypical beliefs associated with mental illness labels and the potential mediating effects of information provided from curriculum content and contact through clinical placement. Methodology Four nursing campuses were sampled, resulting in one hundred and thirty two (n=132) participants. Participants remained the same for all three phases of the repeated measure. A quantitative approach, non-experimental survey design with repeated measures made use of a self-report questionnaire. Section A included demographic data (age, gender and cultural group), while Section B consisted of a semantic differential measure (SDM) focusing on three mental illness labels; schizophrenia, major depressive disorder and bipolar mood disorder. Data was collected on the first day of the psychiatric nursing training block, the last day of the training block, and the first day of the second training block, after approximately six weeks of clinical placement in specialist psychiatric settings. Results Participant scores suggested greater negative stereotypical beliefs associated with the schizophrenia label in all the three phases of data collection. The bipolar mood disorder label was the least associated with negative stereotypical beliefs. Information given during the initial teaching block and contact during the clinical placement period resulted in a slight reduction of negative stereotypical beliefs associated with the schizophrenic label. In contrast negative stereotypical beliefs associated with the bipolar mood disorder label were increased slightly after information and contact. Conclusion and recommendation The results of the study confirmed that health care professionals are not different from the general population in their negative stereotypical beliefs towards mental illness labels. A review of the proposed new nursing curriculum should specifically include emphasis on psychosocial rehabilitation. In addition, clinical placement of the student nurses must be designed to ensure interaction with mental health care users engaged in recovery and community integration to remove perceptions of inability to recover associated with mental illness labels (Adewuya & Oguntade, 2007; Adewuya & Makanjuola, 2008; Corrigan, 2007; Smith, 2010). / M.N. University of KwaZulu-Natal, Durban 2014

Interpersonal violence and abuse in New Zealand is so widespread it is considered a normative experience. Mental health nurses witnessing the inscribed effects of abuse on service users are lead to consider whether we are dealing with a breakdown of the mind or a breakdown in social or cultural connection (Stuhlmiller, 2003). The purpose of this research is to examine the cultural context which makes violence and abuse against women and children possible. In 2003, the public debate on prostitution law reform promised to open a space in which discourses on sexuality and violence, practices usually private or hidden, would publicly emerge. Everyday discourses relating to prostitution law reform reported in the New Zealand Herald newspaper in the year 2003 were analysed using Foucauldian and feminist post-structural methodological approaches. Foucauldian discourse analysis emphasises the ways in which power is enmeshed in discourse, enabling power relations and hegemonic practices to be made visible. The research aims were to develop a complex, comprehensive analysis of the media discourses, to examine the construction of harm in the media debate, to examine the ways in which the cultural hegemony of dominant groups was secured and contested and to consider the role of mental health nurses as agents of emancipatory political change. Mental health promotion is mainly a socio-political practice and the findings suggest that mental health nurses could reconsider their professional role, to participate politically as social activists, challenging the social order thereby reducing the human suffering which interpersonal violence and abuse carries in its wake.

This ethnographic study explores the teaching role of activists and community advocates who have become involved in the education and preparation of mental health professionals. Placed in the transcultural mental health context, the study aims to identify central features of the ?teaching role? of consumer and carer advocates as they have become employed via participatory strategies and employment scenarios within mainstream teaching programs and transcultural mental health centres. The central theme of the study is how consumer and carer advocates teach via the notion of lived experience, a key expression of recent workforce development policy in Australian mental health. The research outcomes from this focus indicate that the teaching work of advocates in contributing authoritative knowledge of self and others is influenced by many factors intrinsic to their performed representative role, rather than exclusively by their personal experience as a consumer or carer, as the policy of lived experience would suggest. I argue that the requirements of teaching as defined by the expectations of employing organisations and the clinical audience, and by traditions in representative advocacy and professional education all shape the way in which advocates build and express their knowledge in educational work.

Made available in DSpace on 2014-12-17T14:47:03Z (GMT). No. of bitstreams: 1 TayssaSCP_DISSERT.pdf: 2247123 bytes, checksum: 1a79620a43fcdfd76a6bad9a24908960 (MD5) Previous issue date: 2013-12-12 / The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN / A Reforma Psiqui?trica brasileira prop?e a cria??o de v?nculos/intera??es do doente mental com a sociedade civil, por meio do resgate da cidadania e da assist?ncia ao doente mental. A desinstitucionaliza??o em sa?de mental preconiza a partir de diretrizes a diminui??o da oferta de leitos hospitalares e consequentemente, a cria??o de servi?os substitutivos de aten??o psicossocial, principalmente, no que tange ?s pr?ticas terap?uticas emancipadoras. A partir desse cen?rio o presente estudo tem como objetivo investigar a atualidade e os desafios do processo de trabalho da enfermagem nos CAPS III no munic?pio de Natal/RN. Trata-se de pesquisa do tipo descritiva com abordagem qualitativa e de car?ter explorat?rio do tipo estudo de caso. Os sujeitos s?o trabalhadores da equipe de enfermagem do CAPS III Leste de Natal/RN. Este servi?o possui a??es voltadas para a aten??o psicossocial dos sujeitos atendidos, com atendimento di?rio pela assist?ncia multiprofissional, comportando a extens?o de atividades de tratamento e acompanhamento, atividades laborais e culturais. Emprega-se a entrevista semiestruturada como instrumento de coleta de dados. A an?lise de dados se fez por meio da An?lise Tem?tica proposta por Bardin. Assim, o presente buscou trazer ? discuss?o de como esse processo se consolida no cotidiano do servi?o. Desta forma, intencionou-se contribuir para o debate sobre a desinstitucionaliza??o na aten??o psicossocial como diretriz da sa?de mental no processo de trabalho de enfermagem em um CAPSIII, Natal/RN

Millions of people in the United States are living with a serious mental illness or substance abuse disorder. These individuals suffer from a high rate of medical co-morbidities. Because of this, patients hospitalized on medical-surgical units for medical reasons often are living with psychiatric/substance abuse co-morbidities, which are not addressed during their medical hospital admission. These patients can be perceived as difficult and even dangerous by nurses who have not received training or education in mental health care. The purpose of this project is to measure medical-surgical nurse’s perceptions of their abilities to recognize psychiatric/substance abuse symptoms and their perception of self-competency to provide appropriate interventions. This project utilized the Behavioral Health Care Competency (BHCC) instrument to measure hospital nurse perceptions of behavioral healthcare competency to determine if additional education and training are needed. The BHCC tool was administered to 19 nurses working on two medical-surgical units in Southern Arizona. Findings support the need for educational intervention, especially in the areas of psychotropic medication recommendation and intervention for patients experiencing hallucinations.

Psychiatric inpatient services provide important care for individuals with serious mental health problems. Studies show that passivity and social disengagement prevail in inpatient settings, and the transition to outpatient care is associated with increased suicide risk. Behavioural Activation is an intervention that targets depression by increasing personally meaningful activities. Preliminary research shows that Behavioural Activation can be used in inpatient settings. The overall aim of this thesis was to evaluate the feasibility and effectiveness of Behavioural Activation for individuals in psychiatric inpatient settings, and in the transition between inpatient and outpatient care. Study I investigated inpatient activities and associated experiences. Study II was a pilot single-case experimental study of the feasibility and effectiveness of inpatient Behavioural Activation. Study III, was an interrupted time series evaluation of nursing-adapted Behavioural Activation across three wards. In Study IV Behavioural Activation in the transition from inpatient to outpatient care was compared to Supportive Therapy in a randomised controlled trial with 64 participants. The primary outcome was that of self-reported depressive symptoms and participants were followed up 12 months after treatment completion. Doing nothing was the most common inpatient activity, along with meal related activities. Passive and solitary activities were associated with negative distress and reward profiles. The preliminary evaluation of Behavioural Activation found high patient and staff satisfaction, and four of six participants showed improvement in depressive symptoms and functioning. After nursing-adapted Behavioural Activation was implemented on three wards, engagement increased. Avoidance decreased but later returned to baseline levels. Depressive symptoms and global clinical severity did not improve after nursing-adapted Behavioural Activations was introduced. The randomised controlled trial found that adding Behavioural Activation in the transition to outpatient care had a small, short-term, advantage over Supportive Therapy for self-reported depression. In conclusion, inpatient disengagement is associated with distress, and Behavioural Activation is a feasible intervention in inpatient settings that can be used by both trained therapists and nursing staff to increase patients’ treatment engagement. Behavioural Activation seems useful in targeting depressive symptoms in the transition from inpatient to outpatient care, a period associated with increased risk of suicide and clinical deterioration.

The purpose of this study was to investigate the Hardiness level of battered women residing at a South Florida shelter and to investigate if there was a major difference in the hardiness level of women who were first time in a shelter as opposed to those who had been previously in shelters. Using a descriptive design, the Health-Related Hardiness Scale was given to 50 battered women residing at a shelter. The results confirmed our hypothesis that proposed that hardier women would leave their abusive environment. The total hardiness of these women was (M= 148.86 SD= 22.64). Furthermore, no major differences were found among the two groups, the total hardiness for the women who been in shelters before was (M=150.17 SD= 26.06) and for those who were first time users was (M=148.45 SD= 21.81). The results provide a baseline to begin to understand the role that hardiness play in the lives of battered women. These findings and future studies may have implications for breaking the cycle of domestic violence.