A paralisia cerebral é definida como uma alteração permanente do desenvolvimento da postura e movimento, causando limitações nas atividades, que são atribuídas a um distúrbio não progressivo que ocorre precocemente no encéfalo em desenvolvimento. A presença de comorbidades psiquiátricas traz piora funcional e na qualidade de vida dessas crianças e seu reconhecimento e tratamento deveriam fazer parte da rotina de centros de reabilitação. Este projeto tem como objetivo estudar as comorbidades psiquiátricas na paralisia cerebral. Foram avaliados 550 indivíduos com diagnóstico de paralisia cerebral, procedentes de um centro terciário de reabilitação física. A comorbidade psiquiátrica mais frequentemente observada foi a deficiência intelectual. Outras comorbidades psiquiátricas frequentes foram os transtornos ansiosos, transtornos do comportamento, transtorno do déficit de atenção e hiperatividade, transtorno do espectro autista e depressão. Embora não fosse o objetivo deste trabalho estudar a ocorrência de epilepsia nessa população, observamos que 43,2% dos nossos pacientes apresentaram essa associação. A presença de transtornos do espectro do autismo foi significativamente maior nos pacientes com epilepsia. A presença de um transtorno psiquiátrico impactou significativamente a percepção da funcionalidade das crianças com paralisia cerebral. Pensar na reabilitação desses sujeitos é levar em conta a presença de transtornos psiquiátricos. A pesquisa ativa de comorbidades deve ser prática rotineira dentro de centros de reabilitação terciários. Pensar em reabilitação do paciente com paralisia cerebral deve extrapolar os objetivos físicos e olhar com a mesma atenção para os aspectos emocionais, comportamentais, acadêmicos e sociais / Cerebral palsy is defined as a permanent change of posture and movement development, causing limitations in activities that are assigned to a non-progressive disorder that occurs early in the developing brain. The presence of psychiatric comorbidity brings functional deterioration and worsens quality of life of these children and their recognition and treatment should be part of routine of rehabilitation centers. This project aims to study psychiatric comorbidities in cerebral palsy. We evaluated 550 individuals diagnosed with cerebral palsy coming from a tertiary physical rehabilitation center. The most frequent psychiatric comorbidity was intellectual disability. Other frequent psychiatric comorbidities were anxiety disorders, behavioral disorders, attention deficit hyperactivity disorder, autism spectrum disorder and depression. Although it was not the objective of this work to study the occurrence of epilepsy in this population, we observed that 43.2% of our patients had this situation. The presence of autism spectrum disorders was significantly higher in patients with epilepsy. The presence of a psychiatric disorder significantly impacted the functionality of children with cerebral palsy. Thinking about the rehabilitation of these subjects is to take in account the presence of psychiatric disorders. The active search of comorbidities should be a routine practice in tertiary rehabilitation centers. Thinking about the rehabilitation of patients with cerebral palsy should extrapolate the physical goals and look with the same attention to the emotional, behavioral, academic and social aspects

D.Cur. (Psychiatric Nursing Science) / Living with chronic mental illness in Namibia is a challenge. It often means a permanent fight against stigma and a daily struggle to make ends meet. The impact of living with the illness produces enormous subjective sufferings for the individuals, as well as untold psychological and financial burdens for many families. Through the researcher‟s interactions with individuals living with chronic mental illness, it became clear that they are not adequately supported by relatives and other members of the communities in which they live. Sometimes they are deprived access to basic needs namely, shelter, medications, freedom of movement and of expression. There is an exaggerated fear of, as well as a negative attitude towards those living with mental illness. In the Northwest Health Directorate of Namibia, there are no community care facilities for individuals living with chronic mental illness. There are no alternative community aftercare modes for discharged individuals living with chronic mental illness. Post-discharge of the patient from the hospital, there are no follow-ups regarding the social circumstances they find themselves in. As a result, the home-care for someone living with chronic mental illness after hospitalization remains the sole responsibility of the relatives who rarely know how to look after the patient. On many occasions the public has been very ignorant about mental illness, resulting in them having a very negative attitude towards persons living with chronic mental illness. The main purpose of this research was to explore and describe the lived experiences of individuals living with chronic mental illness, and the experience of the family members, community members, and health care workers dealing with individuals living with chronic mental illness. Thereafter, the researcher developed a mental health nursing model, which provides a theoretical frame of reference for the advanced psychiatric mental health nurse practitioner to facilitate constructive interactions through communicating, relating and sharing by discharged individuals living with chronic mental illness in Namibia...

D.Cur. (Psychiatric Nursing Science) / The aim of the research was to generate a psychiatric nursing approach for adolescents experiencing mental health problems. Understanding by the psychiatric nurse of all the dimensions of the experience world of the adolescent with mental health problems. can contribute to the development of a psychiatric nursing approach. The psychiatric nurse in an adolescent unit can operationalise the guidelines of such an approach in order to rcalise hope and the quest for wholeness with the adolescent with mental health problems. Nowadays high expectations are put to the adolescent. The adolescent is confronted with prescriptions and expectations by a complex society. The psychiatric nurses in an adolescent unit of a private psychiatric hospital often experienced feelings of confusion. discouragement and frustration. That which they wanted the adolescent to achieve while in the unit. determined what kind of treatment he received. The psychiatric nurse has accepted the responsibility for the adolescent' s quest for wholeness (well-being) and for the changes that could be effected therapeutically. In addition the frame of reference of workbooks and thought books. programmes for adolescents with mental health problems. the desires of parents and the theories and models for adolescent development are used as the frame of reference for treatment. This deprives the adolescent with mental health problems of his expert role as the author and rewriter of his life-story. as well as of the own responsibility for the quest for wholeness and maturity. The researchercame to the conclusion that the adolescent with mental health problems should himself, on the one hand. give the main input in the establishment of programmes in an adolescent unit in a psychiatric hospital and on the other hand. for the writing and rewriting of his own life-story. If the psychiatric nurse wishes to obtain more knowledge and understanding of the experience world of the adolescent with mental health problems, she can, from the frame of reference of the adolescent himself, facilitate hope and the quest for wholeness in order to restore, maintain and promote mental health...

The obesity epidemic among children and adolescents has been growing rapidly over the past 10 years, particularly in Latino children. Multiple researchers have found support for positive associations between parent-child communication and healthy nutrition and exercise behaviors. The present study examined the relations between parent-adolescent communication and parenting style and the dietary and exercise behaviors of Latino adolescents. The study included 79 adolescents between the ages of 13 and 18 years and their parents (100% are Latino). Correlation and hierarchical regression analyses were conducted to determine which parenting style and communication variables are significantly associated with adolescents’ dietary and physical activity behaviors. Based on the Pearson correlation and hierarchical regression analyses, parent reported ‘problems in communication’ was the only variable significantly associated with adolescents’ fast food intake. Overall, the results of this study demonstrate the value of considering family functioning in childhood obesity research and including the family in childhood obesity interventions.

The objective of this thesis is to critically examine the diagnostic divisions of eating disorders as proposed within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). I focus on Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Other Specified Feeding or Eating Disorder (OSFED), although there were several new categories issued in 2013. Using person-centered ethnographic interviews, focus groups, participant observation, and autoethnography, I collected qualitative data to highlight how disordered eaters perceive themselves and their behaviors in relation to their diagnoses. I recruited participants in Boston, MA from Eating Disorders Anonymous (EDA), a decentralized network of support groups for disordered eaters. Subjects in my study, as well as from EDA at large, have a wide variety of diagnoses. Building off anthropologies of the pathological body, embodiment, medicalization and neuroanthropology, I highlight how predominant scripts of mental illness in both popular media and science shape the ways that disordered eaters understand their pathological behaviors. I also examine the historical and contemporary evolution of eating disorder theory within the psychological literature, offering a reflexive approach to the theoretical foundations within the field. Interweaving psychological literature reviews with ethnographic data, I demonstrate that disordered eaters do not fit as straightforwardly into diagnostic categories as presumed. Instead, findings indicate that individuals express different combinations of symptoms that range across diagnostic divisions.

Background: While cognition is the dominant view of understanding in psychology, there appear to be few occupational therapy interventions within this field that are cognitive. Objective: A systematic literature review was conducted to identify how occupational therapists work with interventions that are cognitive in the field of psychiatry and mental health internationally. Methods: Searches were conducted in the Academic Search Elite, CINAHL, PubMed, OVID Medline, Google Scholar, AMED, OTSeeker, PsycInfo and Cochrane Library databases between the years 1997 to 2017 and identified 21 publications for inclusion. Results: Three themes were identified and consequently discussed: Occupational therapy as a cognitive intervention, specifically named as cognitive interventions used by occupational therapists and multi-professional cognitive interventions. Conclusions: The findings indicate that interventions used by occupational therapists on a broad range of psychiatric diagnoses contain everyday occupations such as cooking, grocery-shopping and occupations meaningful to the client. These occupations are the notion of occupational therapy while simultaneously improving the cognition and can be considered to be cognitive. This connection needs to be researched further in the future. Significance: Occupational therapy interventions can be considered to improve on cognition and are therefore important in psychiatry and mental health.

No description available.

Class of 2015 Abstract / Objectives: The study aimed to increase EPS risk factor assessment when prescribers order prophylactic anticholinergics with antipsychotics. An evidence-based pharmacist checklist card was developed to aid in this decision making process. Methods: A retrospective chart review of patients admitted to the acute inpatient psychiatry units at an academic medical center was conducted to determine baseline prophylactic anticholinergic prescribing habits over a two-month period. Charts were included if the patient was at least 18 years old and ordered at least one scheduled antipsychotic during the admission. An educational intervention session introduced the pharmacist checklist card and shared baseline findings. Post-intervention data was collected during a two-month period following the intervention. The percentage of prophylactic anticholinergic orders based upon pharmacist checklist card parameters pre and post-intervention was analyzed using chi-square test. Results: There was a significant decrease in the total percentage of orders for prophylactic anticholinergics from 72.7% in the pre-intervention period to 50.8% in the post-intervention period (p<0.001). Significant changes in the percentage of orders for prophylactic anticholinergics were also found for patients at no-to-low risk for EPS (56.4% versus 31.8%, p=0.014) and at low-to-moderate risk for EPS (79.6% versus 50.8%, p=0.003). There were no significant changes observed in the percentage of orders for prophylactic anticholinergics for patients at moderate-to-high risk for EPS. A lower percentage of patients prescribed a prophylactic anticholinergic experienced adverse effects in the post versus the pre-intervention period (52.31% versus 75.27%, p=0.003). Conclusions: Significant differences were found between pre and post-intervention anticholinergic medication prescribing habits. This suggests that increased patient risk factor assessment in the form of a pharmacist checklist card is effective in decreasing orders for prophylactic anticholinergic medications not clinically indicated and reducing the incidence of adverse effects.

Class of 2015 Abstract / Objectives: To compare the self-reported medication knowledge and attitudes of patients with psychiatric disorders who attended a patient medication education group (PMEG) versus those who did not. Methods: A convenience sample of 288 patients being discharged from an adult inpatient psychiatric unit was used. Just prior to discharge, patients were offered the opportunity to complete a questionnaire to assess their medication knowledge and attitudes. Patients who consented and attended the PMEG were assigned to the treatment group (n=81), while those who did not attend the PMEG were assigned to the control group (n= 207). The survey included nine statements for which the patients selected either agree or disagree. A Rasch analysis was used to analyze scaled questions. Chi-squared tests and Mann-Whitney U were used to analyze nominal and ordinal data, respectively. Demographic data was also collected. An alpha priori of 0.05 was applied. A Bonferroni correction was applied for multiple tests. Results: Patients who attended the PMEG were found to have a higher level of education compared to those who did not attend (p=0.037). There were no significant differences in knowledge and/or attitudes between those who attended PMEG during this admission versus those who did not attend (p=0.065). However, those who attended a PMEG during a previous hospital admission had a more positive attitude toward taking their medications (p=0.025). Conclusions: Results suggest that attitudes toward taking medications may gradually improve over time after patients attend a PMEG during an acute inpatient psychiatric admission.

M.Cur. (Psychiatric Nursing) / With modern psychiatric treatment, patients usually come into contact with as many as six different team members. These team members have their own particular treatment plans for patients. This has prompted the question: "How do patients experience their treatment by the interprofessional health team?" The aims of this study are as follows: • To explore psychiatric patients' experiences of their treatment by the interprofessional health team in a particular private psychiatric clinic. • To set basic guidelines which will promote the optimisation of treatment of psychiatric patients by the interprofessional health team, in order to prevent the aggravation of mental illness, emphasising the contribution of the psychiatric nurse.