Thesis (M.S.)--University of Michigan, 1970.

Thesis (M.S.)--University of Michigan, 1990.

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)

I Sverige lever mellan 20- 40 procent av befolkningen med en psykisk ohälsa. Behandlingen av psykisk ohälsa, utifrån en humanistisk människosyn, inriktar sig på en hälsofrämjande process genom att stödja och stärka individen genom stödjande samtal. Syfte; Syftet med denna studie var att beskriva sjuksköterskors erfarenheter av stödjande samtal inom psykiatrisk öppenvård. Metod; En kvalitativ studie genomfördes där data samlades in med hjälp av semistrukturerade intervjuer av sjuksköterskor inom psykiatrisk öppenvård. Data analyserades med hjälp av en konventionell innehållsanalys. I studien inkluderades totalt 12 sjuksköterskor. Resultat; Stödjande samtal beskrevs av sjuksköterskorna som en viktig och bärande del i relationen mellan sjuksköterska och patient inom psykiatrisk vård. Arbetslivserfarenhet och tillgänglighet beskrevs som betydande faktorer för stödjande samtal. Konklusion; Det fanns en upplevd otydlighet av innehåll och mål med stödjande samtal hos sjuksköterskorna. Otydliga riktlinjer för stödjande samtal kan leda till att sjuksköterskorna blir stressade. Rutiner och struktur är viktiga faktorer och det kan medföra att sjuksköterskorna blir mer stresståliga och finner en ökad trygghet i att utföra stödjande samtal. / In Sweden, 20- 40 percent of people live with a mental illness. The treatment of mental illness is based on a humanistic approach, focusing on health promotion by supporting and strengthening the individual through supportive conversations. Purpose; The purpose of this study was to describe nurses' experiences of supportive conversations in their work with psychiatric outpatients. Method; A qualitative study was conducted, in which data were collected using semi-structured interviews with nurses in outpatient psychiatric care. Data were analyzed by conventional content analysis. The study included a total of 12 nurses. Results; Supporting conversations was described by nurses as an important and fundamental part of the relationship between nurse and patient in psychiatric outpatients. Experience and availability were described as significant factors for supporting conversations. Conclusion; Nurses experienced that content for supporting conversations and aims were indistinct. Indistinct guidelines for supportive conversations may lead to nurses becoming stressed. Routine and structure are important factors that may result in nurses working better under pressure and feeling more confident in supporting conversations.

M.Cur. / Please refer to full text to view abstract

Magister Curationis - MCur / The South African health care system shifted the focus of treating psychiatric disorders from institutional care level mental health services to facilitate this process of integration into the Primary Health Care (PHC) settings. All the provinces were thus engaged in improving mental health care services at community level by providing training for professional nurses in mental health at PHC settings. Consequently, mental health nursing has also changed considerably by shifting the focus of mental health care to the primary care level. It is however, suggested that the current revolving door syndrome experienced at psychiatric institutions was partly due to inadequate community-based psychiatric services. It was also suggested that the attitudes and knowledge of health professionals towards mental illness has a major impact on service delivery, treatment and outcome of mental illness. The aim of this research study was to assess the attitude of nursing staff working at a Community Health Centre (CHC) towards the mental health care user. A CHC was chosen that renders 24 hour services. The inclusive sample included all the different categories of nurses permanently employed at this CHC. The Attitude Scale for Mental Illness questionnaire was used to collect the data. Descriptive statistics: means, median and standard deviations were calculated for the following variables: separatism; stereotyping; restrictiveness; benevolence; pessimistic prediction and stigmatization. In conclusion it can be said that the nursing staff with more experience irrespective of category of nurse has less of a stereotyping attitude towards mental illness. The longer the nurse worked at the setting and irrespective of their nursing qualification the more positive their attitude towards the MHCU became.

Esta pesquisa analisou os Cursos de Enfermagem em Nível Técnico, localizados nas cidades da Regional de Saúde de Araraquara, com relação à Disciplina de Enfermagem Psiquiátrica e/ou Saúde Mental nos anos de 2003 e 2004. A constatação da inconstância dessa Disciplina na grade curricular dos referidos Cursos, especialmente na questão da prática, nortearam esta pesquisa. Para isso, depois de delimitado o universo de pesquisa, foi utilizado um instrumento em forma de questionário semi-estruturado, contendo perguntas fechadas e semi-abertas, o qual foi dividido para análise em três blocos, sendo o primeiro referente a escolas e aos Cursos, o segundo sobre o corpo docente e o terceiro sobre o conteúdo teórico e de estágio da Disciplina de EP/SM. Foi solicitado também o plano de ensino das referidas Disciplinas. A análise procedeu-se de forma qualitativa e quantitativa. Os resultados demonstraram dicotomia entre teoria e estágio, ausência de estágio em vários Cursos, conteúdo dos Planos de Disciplina voltados ao modelo médico-hospitalocêntrico, embora já apresente traços na Reabilitação Psicossocial. A maioria dos docentes trabalha em outros locais além da docência, nem sempre há formação específica na área, mantém-se na forma tradicional de ensino e parecem desconhecer a importância da Disciplina. Pelas indicações esta Disciplina existe apenas para constar na grade curricular dos Cursos. Concluise ser necessária uma mudança urgente neste ensino, além de qualificar e sensibilizar o quadro de docentes para a importância desta Disciplina. / This research analised the nursery courses in the technical level located in the cities of Health Brand in Araraquara, in relation to the subjects of Psychiatric Nursery and/or Mental Health in 2003 and 2004. This research was inspired by the fact that this discipline is not constantly given on the courses mentioned above, especially on the practical matter. So, after limited the universe of the research, an instrument in the form of a semi-structured questionaire was used , consisting of closed and semi-opened questions and it was divided to be analised in 3 categories: the first one referring to schools and the courses, the second about the group of professors and the third about the theorical and research content in the EP/SM discipline. It was also asked for the teaching plan of those mentioned disciplines. The analise was done in the qualitative and quantitative form. The results showed dicotomya between theory and research, lack of research in several courses, discipline plan content focusing the medical-hospitalocentric model, although it already presents traces of psychsocial reabilitation. The majority of the professors works in other places besides teaching, do not have specific learning in the area, keep the tradicional form of teaching and give the impression of not knowing the importance of the discipline. According to the facts, this discipline exists only to be counted as one more in the students´ grades reports. Therefore, it is necessary an urgent change on this course, besides improving and touching the group of professors to the importance of this discipline.

A política de saúde mental preconiza a diminuição da oferta de leitos psiquiátricos e a criação de serviços na comunidade deslocando a responsabilidade pelo seguimento do tratamento da doença mental das equipes hospitalares para as equipes comunitárias, o doente mental e seus familiares. Pacientes com transtornos mentais e seus familiares vivenciam momentos cíclicos de controle e diminuição sobre situações problema, as quais podem ou não resultar em internação psiquiátrica. A família passa a ser a principal provedora de cuidados e apoio aos pacientes psiquiátricos, no meio extra-hospitalar, fator este que pode gerar sobrecarga na família.A sobrecarga familiar é definida como \"um estado psicológico que advém da combinação de trabalho físico, emocional e pressão social\". O período pós a alta hospitalar pode gerar a família grande impacto que ao longo do tempo se modifica. O presente estudo tem como objetivo descrever e comparar a sobrecarga objetiva e subjetiva do familiar cuidador de pacientes no primeiro mês de alta hospitalar e após três meses deste período. Método - Foi aplicada a escala FBIS-BR nos neste primeiros mês e após três meses deste período. Foram entrevistados 26 familiares de pacientes que realizavam seguimento em um serviço de saúde mental ambulatorial na cidade de Ribeirão Preto. Os dados foram analisados através de freqüência e porcentagem e o teste não paramétrico de Wilcoxon-teste t- foi aplicado para identificar os itens da FIBS-BR que se destacaram na sobrecarga familiar. Resultados e discussão:.Os familiares dos 63 pacientes que compareceram as consultas foram convidados a participar do estudos e destes somente 26 aceitaram participar .Os pacientes desta amostra são em sua maioria homens, casados e completaram o ensino fundamental .Com relação aos cuidadores a maioria eram mulheres e mães com média de idade de 51 anos .Os participantes deste estudo são pertencentes a classe social mais baixa. Os diagnósticos mais prevalentes no estudo foram dos seguintes agrupamentos: \"Esquizofrenia, transtornos esquizotípicos,Transtornos delirantes e Transtornos de Humor\" .Os resultados demonstraram que a sobrecarga objetiva destaca-se da subjetiva nos dois momentos analisados. Indicando que os familiares são sobrecarregados com atividades de cuidado do doente, porém não se sentem prejudicados por isso. Possivelmente este resultado indica que os familiares preferem responder que não se incomodam porque entendem que é sua obrigação cuidar do familiar.A sobrecarga do cuidado objetiva e subjetiva diminuiu do primeiro para o terceiro mês e três aspectos podem explicar este resultado : 1- Paciente ainda com sintomas da doença no primeiro mês após a alta hospitalar 2- Readaptação da família após três meses de alta hospitalar; 3- Estratégia de visitas domiciliares pela equipe de saúde. Considerações Finais: Este estudo aponta para a importância e necessidade de acompanhamento dos pacientes egressos e seus familiares. A visita domiciliar é uma estratégia importante pois consegue manter um vinculo mais estreito entre o doentes, sua família e o serviços de saúde mental. A visita domiciliar é parte das atividades do enfermeiro sendo portanto, um dos profissionais da equipe que pode contribuir muito para melhorar as condições de doentes e famílias. / The mental health policy calls for the reduced supply of psychiatric beds and the creation of services in the community by shifting responsibility for monitoring the treatment of mental illness of hospital staff to community teams, the mentally ill and their families. Patients with mental disorders and their families experience moments cyclic control and reduction of problem situations, which may or may not result in psychiatric hospitalization. The family becomes the primary provider of care and support to psychiatric patients in the middle-ofhospital, a factor that can lead to overload in the family. The family burden is defined as \"a psychological state that arises from the combination of physical work, emotional and social pressure\". The post hospital discharge to the family can generate great impact over time changes. The present study aims to describe and compare the objective and subjective burden of family caregivers of patients in the first month of hospital discharge and after three months of this period. Method - was applied FBIS-BR scale in this first month and after three months of this period. Were interviewed 26 relatives of patients who were performing a follow-up outpatient mental health services in Ribeirão Preto. Data were analyzed using frequency and percentage and the nonparametric Wilcoxon t-test was used to identify items of FIBS-BR that stood out in the family burden. Results and discussion: The relatives of 63 patients who attended the consultations were invited to participate in these studies and only 26 agreed to participate. The patients in this sample are mostly male, married and completed their primary education. With respect to most caregivers were women and mothers with an average age of 51 years. The participants in this study are belonging to lower social class. The most prevalent diagnosis in the study were the following groupings: \"Schizophrenia, schizotypal disorder, delusional disorders and mood disorders\". The results showed that the overhead lens stands out in two moments of subjective analysis. Indicating that family members are overwhelmed with patient care activities, but do not feel harmed by it. Possibly this result indicates that family members prefer to answer that do not bother because they understand that it is his duty to take care of the family. The burden of care objectively and subjectively decreased from first to third month and three aspects may explain this result: 1 - The patient has symptoms of the disease in the first month after hospital discharge; 2 Hospital - Rehabilitation of the family after three months of hospital discharge; 3 - Strategy of home visits by health teams. Final Thoughts: This study highlights the importance and necessity of patient follow up graduates and their families. The home visit is an important strategy because it can maintain a closer link between the patient, his family and mental health services. The home visit is part of the activities of nurses and therefore, a team of professionals that can do much to improve conditions for patients and families.

Introdução: A esquizofrenia é um transtorno mental de evolução crônica que causa sofrimento para o doente e sua família. Traz ao paciente prejuízo severo capaz de interferir amplamente na capacidade de atender às exigências da vida e da realidade, podendo torná-lo frágil diante de situações estressantes e aumentar o risco de suicídio. Para a família, a experiência de conviver com um membro portador desse transtorno tem sido comparada à jornada sob a tempestade. Primeiramente, há dificuldade de perceber o aparecimento da doença, com a definição do diagnóstico, os familiares variam em suas reações. Ao entrar em contato com o sistema de saúde mental, a família aprende uma nova linguagem, que é a linguagem dos profissionais de saúde. Essa nova linguagem deverá ser ajustada ao senso comum convencional do contexto familiar, de modo que possibilite compreender e tratar o adoecimento. Assim, a família cria uma linguagem para descrever sua experiência com o adoecimento mental. A pergunta desta pesquisa é: quais expressões as famílias utilizam para descrever o adoecimento de um familiar? Objetivo: identificar as expressões utilizadas por familiares para descrever a experiência de conviver com o adoecimento mental. Metodologia: Trata-se de pesquisa que realiza análise dos relatos de familiares por meio do software Analyse Lexicale par Contexte d\'um Ensemble de Segments de Texte (ALCESTE), contendo uma quantidade considerável de testes estatísticos, organizados para realizar análise de dados textuais. O ALCESTE contém metodologia de análise de dados qualitativos que se adequa a qualquer domínio de investigação, em que se pretenda tratar material textual, principalmente no que se refere à sua composição lexical e estruturação temática. Resultados e Discussão: A análise realizada pelo ALCESTE forneceu quatro classes agrupadas duas a duas: Classe 2 -- início da doença e Classe 4 -- início do tratamento; Classe 1 -- convivência e Classe 3 - cotidiano. Um conjunto de palavras e frases descrevem cada uma das classes. Início da doença: \"começou a doença\", \"adoecimento\", \"antes da doença\". Início do tratamento: \"internações\", \"tratamento\", \"remédio\". Convivência: \"difícil\", \"futuro\", \"esperança\". Cotidiano: \"cuidado\", \"sozinho\", \"preocupa\". Os resultados indicam que o período entre perceber a mudança de comportamento e o diagnóstico, geralmente culminando com a primeira internação, é carregado de sentimentos, de vivências de ter que lidar com comportamentos estranhos, violentos e o isolamento do doente. Depois, quando a medicação fez efeito, vivem um momento mais feliz, com mais esperança e atribuem essa melhora à medicação. Os familiares fazem reflexões sobre o passado, que no início precisavam de mais informações e se as tivessem, talvez a convivência não tivesse sido tão sofrida como foi. Mas o tempo de convivência possibilita melhor compreensão e aceitação da doença. Também desenvolveram algumas rotinas: como não deixar o familiar doente sozinho, observar se ele está tomando a medicação, mantendo, assim, um cuidado supervisionado que se incorporou ao cotidiano familiar. Conclusão: Os momentos descritos pelos familiares foram identificados por expressões, palavras e termos utilizados pelos mesmos em suas narrações. A pesquisa reafirma os dados encontrados nas pesquisas que forneceram as entrevistas analisadas neste estudo. Essas pesquisas anteriores utilizaram método de análise qualitativo tradicional, no qual o pesquisador lê várias vezes o material coletado, destaca as partes relevantes e as agrupa em categorias gerais criadas por ele para descrever o fenômeno investigado. Nesta pesquisa, a organização dos dados, o processo de agrupar trechos, criar classes e estabelecer a relação existente entre as mesmas foi feito com base na análise léxica das palavras de um conjunto de textos fornecido pelo software ALCESTE. Desse modo, a principal contribuição deste estudo foi trazer a linguagem dos familiares para descrever os momentos do adoecimento através de uma metodologia de análise mais distante do pesquisador. / Introduction: schizophrenia is a mental disorder of a chronic course that causes pain for both the patient and his family. It brings the patient severe prejudice that can interfere strongly in the ability to meet the demands of life and reality, making the patient fragile before stressful situations and increase the risk of suicide. For the family, the experience of living with a bearer of this disorder has been compared to the journey under the storm. First, there are difficulties identifying the onset of the disease with diagnostic definition, family members vary in their reactions. When in contact with the mental health system, the family learns a new language, which is the language of health professionals. This new language should be adjusted to the conventional wisdom of the family context, so that makes it possible to understand and treat the illness. Thus, the family creates a language to describe their experience with the mental illness. The question of this research is: which expressions families use to describe the family member\'s illness? Objective: identify expressions used by family members to describe the experience of living with the mental illness. Methodology: it\'s a research that conducts analysis of family reports through a software called Analyse Lexicale par Contexte d\'um Ensemble de Segments de Texte (ALCESTE), which contains a considerable amount of statistical tests organized to perform analysis of textual data. ALCESTE contains methods of analysis of qualitative data that fit for any field of research, treating textual material, mainly related to its lexical structure and composition of subject. Results and Discussion: the analysis performed by ALCESTE provided four classes grouped into two pairs: Group 2 - beginning of the illness and Group 4 - beginning of treatment; Group 1 - familiarity and Group 3 - daily routine. A group of words and phrases describe each group. Beginning of illness: \"the illness started\", \"illness\", \"before the illness\". Beginning of treatment: \"hospitalization\", \"treatment\", \"medicine\". Familiarity: \"difficult\", \"future\", \"hope\". Daily routine: \"take care\", \"alone\", \"it worries\". The results show that the time among noticing the behavior change and the diagnosis, normally culminating in the first hospitalization, it\'s full of feelings, experiences of dealing with strange and violent behaviors and the patient isolation. Then, when medications had effect, they live a happier and hopeful moment, and attribute this improvement to medication. Family members reflect about past, where at first they needed more information and if they had them, maybe familiarity hadn\'t been so painful as it was. But familiarity periods create better comprehension and acceptance of the desease. They also solved some routines: as not letting the sick family member alone, checking if he\'s been taking the medicine, and supervising the familiar routine.Conclusion: The moments described by family members had been identified by expressions, words and terms used by them. The research reassures the data found in the research which provided the interviews analysed in this study. These previous studies used traditional qualitative analysis method, where the researcher reads the collected material several times, highlights the relevant parts and groups them in general categories created by him to describe the phenomenon under investigation. On this research, data organization, the process of grouping parts, creating groups and establishing the relationship between them were performed based on the lexical analysis of words from a group of texts provided by ALCESTE software. This way, the main contribution of this study was to bring the language of the family members to describe the moments of illness through an analysis methodology farther from the researcher.