This study looked at physicians' perceptions of the existing process of referral and collaboration between themselves and psychologists. Specifically, this study sought to identify the barriers to referral and collaboration in an effort to improve referral and collaboration between these two fields. A total of nine family physicians were interviewed. Overall, the barriers that were identified by physicians included a lack of feedback provided by psychologists, a low level of collaboration with psychologists, physicians' perception of the financial inaccessibility of psychological care, the lack of information that physicians have on psychologists, and physicians not knowing the resources that were available. Addressing these barriers appears to involve some combination of improving psychologists' feedback and collaboration with physicians, providing physicians with information and education on psychologists and their services, and improving the financial accessibility for patients to receive psychological services. / xiii, 156 leaves ; 28 cm.

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The study seeks to explore and to offer a critical account for the 'discursive doings' of student psychiatric nmsing practice as they are jointly constructed in the episodes of conversation between the nmse and client-speakers within the context of the communitybased psychiatric clinic. The study is built around a social constructionist framework and is concerned with the analysis of the discursive activities present within seven (7) transttibed, audio-recordings of student nurse-psychiatric client interactions. A thick and sometimes critical description of three of the contextual forces back grounding/foregrounding the discursive processes of psychiatric nursing is given. These include the public health psychiatric care context, the problem-solving approach of the undergraduate psychiatric nursing curriculum and the assumption and effects of modem psychiatric nursing theory. The first level of analysis is an aspect of the methodology and offers a descriptive and interpretive analysis of the talk in the texts. Various conversational discourse analytic tools were used here to transform talk into text and to develop the starting point for the subsequent positioning theory analysis. The second level of analysis is a positioning theory analysis of happenings within these texts. Some of the textual descriptions generated in the first level of analysis are used to illuminate and to add substance to the accounts of these positioning theory happenings. The analysis has shown that from a social constructionist positioning perspective, the unfolding nurse-client dialogue in these texts operates in four potentially distinct ways - highlighting, herding, hectoring and heeding - with specific effects for their going on together in conditions of relationship. These ways of talking are shown to be contrary to the person-eentered rhetoric of modem psychiatric nursing and more aligned with the bio-medical format of talk in helping contexts. Can these activities be dismissed as non-nursing activities? The implications for a modem psychiatric nursing theory that holds the person-centred approach to be its quintessential essence are considered and a number of ideas for how client-authorised expressions may be jointly manifest in conversations situated in this practice context are offered. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

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Bakgrund: Ett mångkulturellt samhälle kan vara en utmaning för sjukvårdspraxis. Tillit är viktigt för att kunna bygga en välfungerande relation mellan en patient och vårdgivare. Syfte: Syftet med studien är att beskriva sjuksköterskors erfarenheter av att främja tillit hos invandrarpatienter med psykossjukdomar  Metod: Fem sjuksköterskor intervjuades med hjälp av semistrukturerade intervjuer. Deltagarna jobbar inom psykiatriska vårdenheter i Stockholm. En kvalitativ design användes i denna studie. Resultat: Resultatet diskuteras utifrån de fyra kategorier och två underkategorier som uppkom i studien: Kommunikationens betydelse för tillitsskapande i psykiatrisk vård, med underkategorin värdet av tolksamtal; kroppsspråkets betydelse för tillit; kulturella skillnader gällande psykiska sjukdomar, med underkategorin kulturella skillnader i att beskriva sjukdomssymptom; närståendes betydelse för ett tillitsskapande möte. Resultaten visar att språksvårighet är ett hinder för kommunikation och för främjandet av tillit hos patienter med invandrarbakgrund och tyder på att empati och lyhördhet är grunderna för att främja tillit och skapa förtroende Diskussion: Resultaten visar att där språket inte räcker till blir den icke-verbala kommunikationen viktig. Studien beskriver också brister av kunskap, pedagogik och förhållningssätt i mötet med invandrarpatienter som har psykisk sjukdom och behovet av transkulturell utbildning inom sjukvården. / Background: A multicultural society can be a challenge for. Trust is crucial for building a well functioning relationship between a patient and a caretaker. Aim: The aim of this study was to describe nurses' experiences with promoting trust in immigrant patients with psychosis. Methods: Five nurses were interviewed with the help of semi-structured interviews. The participants work in psychiatric care units in Stockholm. A qualitative design was used for this study. Results: The results are described in four categories and two subcategories that are raised in the study: the importance of communication for creating trust in psychiatric care, with the subcategory interpreted conversation; the importance of body language for trust; cultural differences regarding mental illnesses, with the subcategory cultural differences in describing illnesses; and the signification of relatives in creating at trustful meeting. The results show that language difficulties is a barrier for communication to promote trust in psychiatric patients who are immigrants and suggests that empathy and responsiveness are the foundations for promoting trust. Discussions: The results suggests that non-verbal communication becomes important when language is not enough. The study also describes deficiencies in knowledge, education and approach in the meetings with mentally ill immigrant patients and the need for transcultural training in health care.

Scientific research is just beginning to empirically prove what people who practice somatic disciplines have known for years. In this thesis, I theorize that it is possible to combine yoga and somatics with modern research into the mind and body in a manner that could facilitate healing in a holistic, beneficial manner. There is an indisputable relationship between a person's overall physical and mental health. The practice of yoga strives to facilitate both physical and mental health, in addition to inner peace and well-being. By identifying similarities between the teachings of yoga and modern kinesthetic research, it is possible to gain a better understanding of why and how yoga makes practitioners feel better.

Bakgrund: Patienter med psykisk sjukdom har en ökad risk att utveckla somatisk sjukdom. Antalet vårdtillfällen inom psykiatrisk slutenvård har ökat under det senaste decenniet. Sjuksköterskan ska kunna observera, åtgärda och hantera patientens såväl psykiska som fysiska omvårdnadsbehov och hon ska även ha en helhetssyn och ett etiskt förhållningssätt. Sjuksköterskan har även en skyldighet att arbeta utifrån vetenskap och beprövad erfarenhet. Syfte: Syftet med studien var att undersöka sjuksköterskors upplevelser av att vårda patienter med somatiska tillstånd inom psykiatrisk slutenvård. Metod: Denna studie är en empirisk intervjustudie som har genomförts med en deskriptiv kvalitativ ansats. Halvstrukturerade intervjuer med fyra sjuksköterskor verksamma inom psykiatrisk slutenvård utgör materialet till denna studies resultat. Materialet har analyserats med en manifest innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier vilka beskriver informanternas upplevelser. Kategorierna är: 1) Upplevelser kring somatisk omvårdnad, 2) Vikten av kunskap samt 3) Samarbetet mellan den psykiatriska och somatiska sjukvården. Slutsats: Majoriteten av studiens informanter upplever att det somatiska omvårdnadsarbetet är svårhanterligt. Deras resurser är begränsade när somatiskt sjuka patienter vårdas på avdelningen. Det finns även en upplevelse av att det är svårt att hålla sig uppdaterad gällande somatiska kunskaper och att det därför finns ett behov av fortbildning avseende dessa. Informanterna upplever även att vården är uppdelad trots att vissa patienter är i behov av kompetensen och yrkeskunnandet från både den somatiska och psykiatriska sjukvården. Klinisk betydelse: Förhoppningen med studiens resultat är att ge en ökad insikt kring vilka faktorer som påverkar sjuksköterskans upplevelser av att vårda patienter med somatiska tillstånd inom psykiatrisk slutenvård. / Background: Patients with mental illness are at increased risk for physical illness. The number of patients that are admitted to the psychiatric inpatient care has increased over the past decade. The nurse should be able to observe and manage the patient's mental need as well as their physical needs. They should also have a holistic and ethical approach and their work should be based on evidence and science. Aim: The aim of this study was to explore nurses' experiences regarding the care of patients with somatic conditions in psychiatric inpatient care. Method: This study is an empirical study with a descriptive qualitative approach based on semi-structured interviews with four nurses working in a psychiatric inpatient ward. A manifest content analysis was used to analyze the interview material. Results: The analysis emerged into three main categories which describe the experiences of the nurses. The categories are: 1) Experiences of somatic care, 2) The importance of knowledge and 3) Cooperation between the psychiatric and somatic care. Conclusion: The majority of the nurses in this study felt that the somatic care was difficult. Their resources are limited when somatically ill patients are admitted to the ward. They also experience that it is hard to keep the knowledge updated regarding somatic care and that there is a need for training. The nurses also felt that health care was divided between the somatic and the psychiatric care, although some patients are in need of the expertise and professionalism from both the somatic and psychiatric care. Clinical significance: The results of the study may contribute to provide a greater understanding of which factors that influence nurses' experiences of the care of patients with somatic conditions in psychiatric inpatient care.

The purpose of the study was to examine the effect of STIPS case note documentation and SOAP case note documentation on counseling trainees' perceived case conceptualization abilities. By training master's level counseling students in the use of case note writing and then asking them to rate their perceived conceptualization this study looked at an area of training that has received little attention in the past. This study attempted to begin the process of understanding if case note documentation could be an area that could help counseling students develop their case conceptualization skills.Quantitative and qualitative data analysis was utilized due to the exploratory nature of this study. The quantitative portion examined how the case note documentation affected trainees' perceived case conceptualization abilities while the qualitative portion examined patterns in the responses of participants to open-ended questions about case note documentation.The quantitative results showed that there was no significant difference between the groups in terms of their perceived case conceptualization. The qualitative results indicated that there are benefits and drawbacks to both the STIPS and the SOAP case note formats. / Department of Counseling Psychology and Guidance Services

Background For patients in need for psychiatric care who refuse treatment, coercive care might be necessary due to The Law of Psychiatric Compulsory Care, LPT. The purpose of this law is to make sure the patient later on will be able to increase autonomy. The most frequent patients in coercive care suffer from psychosis, heavy depression or having high risk of committing suicide. One of the most important tasks in the nurse profession is to increase patients’ autonomy. Therefore having ethical judgment is necessary to know when to use paternalism. To take note of patients’ experiences may increase awareness, making care more patient-centered. Aim To describe patients’ experiences of coercive care and coercive interventions in psychiatric care. Method A literature review has been conducted in order to compile what is currently known about the topic at hand. The result is based on ten scientific articles with findings responding to the aim of this study. The articles have been analyzed by identifying similarities and differences that have synthesized to a new whole.   Result The literature review yielded a profound view of patients’ experiences when being in coercive care. Three main themes were found to cover the phenomenon. Those were Coercive Care - limits and possibilities, The care relationship is fundamental and From abuse to life saving. Discussion The result has been discussed using the theory about Care Suffering, as described by Katie Eriksson. This theory is applicable on the context of interest. The findings has also been discussed using earlier studies concerning coercive care, as well as studies emphasizing the perspective of the nurse’s using coercive restraint. Key words Coercive care, coercive interventions, psychiatric care, patients’ experiences.

The aim of the research was to explore the subjective experience of patients admitted to a psychiatric hospital. Sub-aims were to explore how these experiences relate to self management, stress and psychological well-being. This study was motivated by research literature that documents a wide variety of negative experiences by patients. A recent psychiatric patient survey conducted in England and Wales (Mind, 2004) found that more than 50% of respondents indicated that hospital surroundings had not helped their recovery. In fact, close to a third of those thought that it had a detrimental effect on their health. Wood and Pistrang (2004) found that psychiatric patients often represent a lower status, marginalized group in society and thus their views are often not taken into account in mainstream research. These results, however, were overwhelmingly based on research conducted in an American or European context. The South African context is unique in the sense of our political, economic and social issues that influence people's perceptions. In relation to other developing and developed nations little research has been done. The research was conducted at a large Psychiatric hospital in Pretoria South Africa. An availability sample of five adults from the hospital was used. A qualitative case study method design was used. Data were obtained through interviews and analysed using Interpretive Phenomenological Analysis (PA) (Smith, 1996; Smith et al., 1997, 1999) Using the IPA method the data was analysed to extract significant or relevant points related to the research topic. These themes were then collated with themes that occur in other accounts and from there tested against the hypothesised outcomes of the investigation. Positive experiences and negative experiences were identified as the main themes; these were each divided into sub themes. The negative experiences related primarily to interaction with hospital staff and -environment, while positive experiences primarily related to effective treatment. Implications of results are that patient experiences and perceptions may be more influential for long term psychological wellbeing than has been acknowledged by care givers within larger mental healthcare facilities. It was concluded that many if not all of the results of previous studies were confirmed. Additionally this study recognised that singular positive experiences may to a greater degree influence patients recovery and maintenance than a combination of negative experiences. Recommendations following from the findings include further studies to assess enhanced interpersonal skills training for nursing staff, and greater community based care facilities. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2006.