M.Cur. / The purpose of this research study was to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. In view of existing problems, such as inadequate preparation of professional nurses for the role of a psychiatric clinical facilitator, inability of student nurses to reflect on their learning and integrating theory into practice, nursing education is faced with a greater need to change from traditional teaching-learning approaches to current student-centred approaches that advocate self-directed learning in student nurses. To achieve this goal in a psychiatric clinical setting, it is necessary to shift the emphasis from instructional teaching to facilitation of reflective learning that results in autonomy and self-reliance in student nurses. Klopper (1994, Monograph 2:24) indicates that the clinical facilitator’s guidance to deep holistic learning is not sufficient on its own. The clinical facilitator should be a reflective practitioner and intentionally facilitate a reflective learning environment for student nurses in a psychiatric clinical setting. The research questions that emerged were: • What is a “reflective learning environment” in a psychiatric clinical setting? • How can a “reflective learning environment” be facilitated for student nurses in a psychiatric clinical setting? To realise the purpose of this research, the following objectives were formulated: • to clarify the concept “reflective learning environment” in a psychiatric clinical setting; • to explore and describe the perceptions of student nurses and clinical facilitators with regard to how a “reflective learning environment” could be facilitated for student nurses in a psychiatric clinical setting; and • to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. The paradigmatic perspective for this research is adopted from the Theory for Health Promotion in Nursing (RAU 2002:4). The functional approach of Botes (1995:13) was used in this study, since it implies application of knowledge. The research design and method used were qualitative, exploratory, descriptive and contextual in nature. The design was divided into two phases. Phase One involved two steps. Step One included the concept analysis of a reflective learning environment through a literature search of all relevant international and national literature on a reflective learning environment. The method of data collection involved a library search – CD-Rom, the Internet, journal articles, books and subject dictionaries - that were used to arrive at attributes that clarified the concept “reflective learning environment” in a psychiatric clinical setting. Concept analysis was done according to the steps described by Wilson (in Walker & Avant, 1983:39). Content analysis of literature was done using deductive, inductive reasoning strategies, synthesis, and inference as described by Chinn & Kramer (1995:63-67), Mouton (1996: 71, 80, 168) and Walker and Avant, (1983:58-62). Theoretical validity was ensured (Mouton, 1996:117). Step Two included the exploration and description of perceptions using agenda focus group interviews held with student nurses and clinical facilitators. The student nurses and clinical facilitators were selected from a psychiatric clinical setting. Both samples were purposively selected. The results of concept clarification conducted gave direction to the agenda focus group interviews that were held with the student nurses and clinical facilitators during the perception survey. The question for the agenda focus group interview with the student nurses was as follows: What are your perceptions with regard to how a reflective learning environment can be facilitated for student nurses in a psychiatric clinical setting? The question for the clinical facilitators was as follows: What are your perceptions with regard to how you can facilitate a reflective learning environment for student nurses in a psychiatric clinical setting? An audiotape was used to record the interviews for later verbatim transcription. Communication techniques, observation and field notes were used during the data collection. Data from both the student nurses and clinical facilitators were analysed according to the qualitative content analysis, as described by Miles and Huberman (1994:241-243). An independent coder, who was purposively selected, was used independently from the researcher in the categorisation of attributes of a “reflective learning environment” that emerged. To ensure trustworthiness in this qualitative research, Lincoln and Guba’s model (1985:290-314) was used throughout the study to ensure the rigor of the study. Ethical considerations were maintained throughout the research study (Denosa, 1998: 1-6; Burns & Grove, 1993:98-104; De Vos, 1998:27-28). Phase Two consisted of conceptualisation of findings from Phase One. Guidelines were formulated based on concluding statements from conceptualisation of the findings. An evaluation of the study was made. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly. The study was conducted contextually and no generalisations should necessarily be made.

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M.Cur. (Psychiatric Nursing) / Please refer to full text to view abstract

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

by Chien Wai Tong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 95-103). / ACKNOWLEDGEMENTS --- p.i / ABSTRACT --- p.ii / TABLE OF CONTENTS --- p.iv / LIST OF TABLES --- p.vii / LIST OF APPENDICES --- p.viii / Chapter CHAPTER 1 --- INTRODUCTION / Background of the Study --- p.1 / Purpose of the Study --- p.3 / Chapter CHAPTER 2 --- LITERATURE REVIEW / The Concepts of Physical Restraint --- p.4 / Rationale or Predictors of Restraint Use --- p.7 / Effects & Consequences of Restraint Use --- p.10 / Alternative Measures to Restraint --- p.12 / Nurses' Reactions to Restraint Use --- p.15 / Ethical Consideration of Restraint Use --- p.17 / Guidelines & Policy in Restraint Use --- p.21 / Decision-making in Restraint Use --- p.23 / Summary --- p.26 / Chapter CHAPTER 3 --- METHOD OF THE STUDY / Objectives of the Study --- p.28 / Choice of Approach --- p.28 / Design --- p.30 / Pre-pilot Preparation --- p.30 / Sampling --- p.30 / Data Collection --- p.32 / Access --- p.35 / Ethical Considerations --- p.36 / Pilot Study --- p.37 / Data Analysis --- p.38 / Issues of Reliability & Validity --- p.41 / Chapter CHAPTER 4 --- RESULTS & DISCUSSION / Introduction --- p.45 / Ward Profile --- p.46 / Demographic Characteristics of Interviewees --- p.49 / General Summary of the Major Categories Regarding Restraint Use --- p.50 / Categories with Similar Sub-themes in the Three Wards --- p.52 / Categories with Different Meanings in the Three Wards --- p.76 / Summary --- p.86 / Chapter CHAPTER 5 --- CONCLUSIONS: LIMITATIONS & IMPLICATIONS FOR PRACTICE / Limitations of the Study --- p.87 / Implications for Nursing Practice --- p.89 / Recommendations for Further Research --- p.91 / Conclusions --- p.92 / REFERENCES --- p.94

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (D.N.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01