published_or_final_version / Architecture / Master / Master of Architecture

Psychiatric morbidity in the postpartum period has been a subject of research for years that has been plagued by much controversy. Most of the studies have come from Western countries. Studies that were done in Africa have concentrated on psychotic disorders in in-patients. A pilot study done by Cheetham et al (1981) at King Edward VIII Hospital found a high incidence of 'transient situational disturbances', which required further investigation. AIMS AND OBJECTIVES: 1. To document the spectrum of psychiatric morbidity in an out-patient population of postpartum Zulu women; 2. To define predictive factors which would identify women 'at risk'; 3. To assess the feasibility of 'Western' screening instruments; 4. To investigate whether 'postpartum blues' occurs in Zulu women. RESEARCH DESIGN A prospective, descriptive study was undertaken. Sample Selection: 177 postpartum Zulu women attending the ' Well-Baby' Clinic at King Edward VIII Hospital were randomly selected for inclusion in the study. Methodology: Three questionnaires: The General Health Questionnaire- 30, Pitt's Questionnaire of Anxiety and Depression and The Kennerley Blues Questionnaire were administered to the subjects. A Structured Clinical Interview DSM-III (SCID) was conducted in those women with symptoms. FINDINGS: 1. The majority of the sample were between the ages of 20 and 30 years, unmarried, with a Senior Primary education and a baby of 20 weeks. 2. 45.76% of the sample had a psychiatric diagnosis, with 18.07% having major depression. Other disorders included: adjustment disorders, schizophrenia and dysthymia. 3. Significant variables using Chi-square analysis were: inadequate antenatal care, a negative response from the partner and the absence of cultural rituals. No association was found with demographic and obstetric variables. 4. T-test analysis showed a correlation between the questionnaires and the SCID. 5. 37.3% had experienced 'postpartum blues'. CONCLUSIONS: 1. The spectrum of psychiatric morbidity is affective in nature and similar to other studies. 2. 'Postpartum blues' does occur in Zulu women. 3. Antenatal screening with 'Western' instruments could reduce psychiatric morbidity. 4. The nomenclature of puerperal disorders is inadequate and needs review. 5. More prospective, community-based research is needed, especially in rural Zulu women. / Thesis (M.Med.)-University of Natal, Durban, 1992.

<p>Much evidence exists that nurses are leaving the public health sector for the private sector, or leaving the country to seek better working conditions and higher salaries. Studies conducted on the job satisfaction of nurses are proof that there is a need to know more about the factors that influence their sense of job satisfaction. Most of these studies focus on the general nursing context. Due to its unique circumstances, many studies abroad have identified the field of psychiatric mental health nursing to investigate job satisfaction of nurses. The minithesis is an attempt to fill the gap that exists in job satisfaction studies in South Africa of nurses in a provincial psychiatric hospital. The study was a cross sectional, correlational, survey design study. The instrument was a self-administered questionnaire, combining a quantitative questionnaire with one qualitative open-ended question. The study was conducted on nurses of all categories in a provincial psychiatric hospital in the Western Cape. Sixty- eight nurses participated in the study. The data was analyzed statistically using the SAS v9 statistical software and Statistical Package for Social Sciences (SPSS). The open-ended question was analyzed qualitatively. The results revealed that the participating nurses were dissatisfied with remuneration, recognition and appreciation, training and development, as well as benefits and incentives. Nurses were most satisfied with supervision and support, interpersonal relationships, and rendering patient care. The study identified the factors influencing job satisfaction and job dissatisfaction of nurses in a provincial psychiatric hospital. Recommendations were made based on the results of the research.</p>

The objective of this study was to explore clients' perceptions and expectations of therapeutic interaction with nurses at Escoval House Community Psychiatric Clinic in Durban. Following the shift of psychiatric care from institutionalised care to community based psychiatric care, it was anticipated that the findings of the study would help to sensitise the primary health care nurses and community psychiatric nurses on how clients perceive the way nurses interact with them. This would help the nurses to ensure satisfactory interactions that would be therapeutic and enhances clients' recovery and well -being. The study utilized Human Relations Counselling Model in exploring the clients' perceptions. An exploratory descriptive survey was used to conduct the study, The study combined both qualitative and quantitative methods for the purpose of triangulation. Ten participants were involved in a focus group and one-hundred and sixty clients participated by filling in questionnaires. Simple random sampling method was used to select participants for both the focus group interview and those who filled in the questionnaires. Data from the focus group was analysed manually using content analysis. Data was presented by participants' direct quotes. Data from the questionnaires was analysed using Statistical Package for Social Sciences (SPSS). For the quantitative data analysis, frequencies and percentages were used to analyse the data. Findings of the study were presented in tables and graphs. Although previous studies on clients' satisfaction have reported clients' satisfaction with mental health service delivery, the findings of this study have revealed that gaps still exist in quality of care delivered to these clients. Findings show that there were mixed perceptions on the way nurse interact with clients during clients' monthly attendances. / Thesis (M.N.)-University of Natal, Durban, 2003.

Bakgrund: Sjuksköterskor verksamma inom psykiatrisk vård upplever svårigheter med att artikulera sin yrkesidentitet. Bakgrunden beskriver sjuksköterskans roll inom psykiatrisk vård ur ett historiskt samt nutida perspektiv. Bakgrunden visar att sjuksköterskor tenderar att lämna den psykiatriska vården när de upplever att deras kompetens inte tas tillvara, vilket i förlängningen även drabbar patienterna. Syfte: Syftet var att beskriva hur sjuksköterskor yrkesverksamma inom psykiatrisk vård uppfattar sin yrkesidentitet Metod: Fem sjuksköterskor intervjuades med hjälp av ostrukturerade intervjuer. Kvalitativ design användes i studien. Resultat: Resultatet presenteras i temat en komplex yrkesidentitet samt tre kategorier: att vårda unika människor, att vara arbetsledare och den egna utvecklingen samt åtta underkategorier Diskussion: Resultatet diskuteras utifrån Imogene Kings begrepp roll, organisationer, auktoritet, makt, status och stress, samt utifrån genusteoretiskt perspektiv. / Background:Nurses working in psychiatric care experience difficulty in articulating their professional identity. The background describes the role of the nurse in psychiatric care from a historical and contemporary perspective. The background shows that nurses tend to leave the psychiatric care when they feel their skills are not utilized, which in turn also affects the patients. Aim: The aim of the study was to describe how nurses working in psychiatric care understand their professional identity Methods: Five nurses where interviewed with the help of unstructured interviews. A qualitative design was used for the study. Result: The results are presented in the theme a complex professional identity and the three categories: nurturing unique people, to be supervisors and their own development as well as eight subcategories Discussions: The results are discussed from Imogene King's conceptual role, organizations, authority, power, status and stress, and on the basis of gender theory perspective.

Background and Research Problem: It is well-known that nurses around the world are exposed to various forms of violence at their workplaces. In psychiatric facilities, many of these incidents are perpetrated by patients against nurses. There is a perception that the current legislation and regulations in the country do not adequately protect psychiatric nurses (health care workers in general) against workplace violence. The preliminary literature suggested that most quantitative studies on workplace violence in psychiatric facilities have concentrated on secondary and tertiary psychiatric hospitals looking at the prevalence, the association between demographic factors and violence behaviour, nurses‟ therapeutic responses, and the impacts on the quality of care. Studies on workplace violence in a psychiatric facility for adults with intellectual disability in the country are limited. Secondly, it appeared from the preliminary literature review that similar studies have not looked at this phenomenon from the individual resilience perspective.Therefore, this study will seek to determine the factors associated with the psychological response of nurses‟ victims of inpatient violence in a psychiatric facility for adults with intellectual disability in Cape Town.Aim: To determine factors associated with the psychological response of nurses‟ victims of in-patient violence in a psychiatric facility for adults with intellectual disability in Cape Town. Objectives: To describe the (1) individual resilience of nurses working at a psychiatric facility for adults with intellectual disability; (2) psychological response of nurses‟ victims of in-patients‟ violence at a psychiatric facility for adults with intellectual disability; and (3) association between the individual resilience characteristics and the psychological responses of nurses victims of in-patients‟ violence in a psychiatric facility for adults with intellectual disability.Methodology: Descriptive-exploratory design using a quantitative approach was used.All categories of nurses (professional nurse, enrolled nurse and enrolled nursing assistance) working at the psychiatric facility for adults with intellectual disability were eligible for the study. Convenient sampling was conducted to select 127 participants who met the inclusion criteria. Self-administered questionnaire was used to collect data. Data was analysed using the SAS V9.3 computer programme. Ethical clearance was obtained from University as well as approval from the management of the psychiatric facility prior to approaching the study participants. Results: The results of the study showed high level of resilience among nurses on Assessment of Resilience Scale (82.9%, n=104); nurses psychological responses to violence were equally distributed between avoidance (mean =4.65 and SD=1.36), intrusion (mean= 4.55 and SD=1.50), hyper arousal (mean=4.46 and SD=1.60) resulting in total mean of 13.67 (SD=4.14) on the revised Impact of Event Scale (IES-R). Measure of association between resilience and the impact of violence on the psychological wellbeing of nurses showed that nurses with high resilience score (82.9%, n=104) fitted the symptoms of PTSD on the IES-R. Spearman Rank correlations (r) analysis showed the total scores of IES-R (r=0.04, p=0.68), avoidance (r=0.01, p= 0.34), intrusion (r=0.08,p=0.34), and hyper-arousal (r= -0.002, p=0.97). Further research looking at the nurses‟ reliance and their responses using resilience theory is needed. / Magister Curationis - MCur

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

The purpose of this Heideggerian phenomenological study was to understand the meaning of the lived experience of seclusion in a psychiatric hospital. Five people with a long standing mental illness who had spent time in a locked seclusion room in a psychiatric hospital were asked to describe their experience in seclusion.Consistent with the method, purposive sampling was used in order to obtain an understanding from those who had lived the experience of seclusion and could articulate their experience. Interviews were audiotaped and the data were transcribed by the researcher. Audiotapes were destroyed when the study was completed. Transcribed data were shared with other researchers who were familiar with Heideggerian phenomenology and hermeneutics for the purpose ofgaining insight into the interpretations. When data were shared, names of participants and other identifying information were removed. Sharing of data for purpose of interpretation is inherent in the Heideggerian method as described by Diekelmann, Allen, and Tanner (1989). Data were analyzed using Diekelmann, Allen, and Tanner's (1989) seven stages. The following patterns emerged constituted pattern- Seclusion, A Paradox Being Powerless yet Hopeful with the supporting themes of 1.) Being Punished, 2) Being Abandoned, and 3) An Opportunity for Reflection and Self Growth. / School of Nursing

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

Syftet: Syftet med studien var att belysa specialistutbildade sjuksköterskors erfarenheter av transkulturell omvårdnad inom psykiatrisk vård. Metod: Studien genomfördes med en kvalitativ metod med enskilda semistrukturerade intervjuer. Specialistutbildade sjuksköterskor som arbetat inom psykiatrisk vård minst ett år fick berätta om sina erfarenheter av transkulturell omvårdnad.  Resultat: I resultatet framkom det att specialistutbildade sjuksköterskor inompsykiatrisk vård upplever språket som ett hinder för omvårdnaden eftersom språket är så centralt inom psykiatrisk vård då samtal utgör en stor del under vårdtiden. Det visar också att religiösa och kulturella seder kan ha betydelse i möten med patienter från olika kulturer. Möjligheter att förstå varandra mellan personal, patienter och anhöriga som är delaktiga i vården lyfts fram. Anhöriga kan bidra med information och även stötta patienterna vilket är värdefullt för omvårdnaden. Tolk används ofta för att lösa kommunikationsproblem men de används inte i så stor utsträckning man skulle önska på grund av kostnader. Slutsats: De specialistutbildade sjuksköterskorna har i stor utsträckning, kunnat ta hänsyn till patientens önskemål och erbjudit patienten det bästa möjliga alternativ till god omvårdnad. Studien visar att det finns specialistutbildade sjuksköterskor inom psykiatrisk vård som anser sig behöva mer kunskap inom transkulturell omvårdnad. / Aim: The study focuses on advanced trained psychiatry nurse’s experiences of transcultural nursing in psychiatric care. Method: The study was conducted using a qualitative method of individual semistructured interviews. Nurses working in psychiatric care could share experiences of transcultural nursing. Results: In the result, one finding was that nurses perceive differences oflanguage as a barrier in the care, because communication is central in psychiatriccare. Religious and cultural beliefs and practices may also have an impact on the meeting with a patient from a different culture. There is opportunity for enhanced mutual understand when relatives are involved in the care. They can provide more information as well as support to the patient. Interpreters are used to solve communication problems; however they are not engaged as often as they should, due to the cost. Conclusion: That nurses, to a large extent, have been able to take into account patient’s wishes and thereby been able to offer the best possible treatment optionsto the patient. The study finds that nurses in general need a wider knowledge of transcultural nursing.