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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.

Several studies show that the clinical reality in psychiatric care does not correspond to the demand of consumer participation from a variety of policy documents that has been produced recently. Studies also show that there is a lot to do in improving, patients with sever mental illness, becoming more involved in their own care. The nurse has a central role in this work. The Norwegian nursing theorist Jan-Kåre Hummelvolls holistic, existentialistic model for psychiatric nursing were used as theoretical ground. The aim of this study was to examine how nurses in psychiatric outpatient units, caring for patients with psychotic disorders, experiences consumer participation. Qualitative phenomenological method was used. Semi-structured interviews with six nurses caring for patients suffering from psychotic disorders in outpatient units were conducted. The interviews were recorded and transcript by the author and then analyzed using qualitative content analyze. Two themes were identified: To follow the road chosen by the patient and When consumer participation risks failing. The result of this study shows that there are several factors that influences nurses job to involve patients in their care. The interviews also showed that there were areas where consumer participation was more problematic. To share a decision with the patient is a way to improve consumer participation. Shared decision making is a complicated process where the nurse needs support to succeed. In pharmacological issues nurses must continue working with consumer participation.

Bakgrund: I denna studie defineras etnicitet som ett samlingsbegrepp för ursprung medan kultur som ett socialt inlärt beteende och är föränderlig i sitt sammanhang. I litteraturen framkommer att patienter med annan etniskt och kulturell bakgrund objektiviseras av sjukvårdpersonalen, individen betraktas som en representant för sin kultur. I Sverige finns många människor med annan etnisk och kulturell bakgrund. Människor som emigrerar drabbats av psykisk ohälsa i högre grad än genomsnittsbefolkningen de löper större risk för stress, oro och ångest. Syfte: Syftet med studien är att beskriva specialistsjuksköterskors möte med en patient som har en annan etnisk och kulturell bakgrund och vårdas för psykisk ohälsa. Metod: Datainsamlades via intervjuer av fem specialistsjuksköterskor. I denna studie används en kvalitativ innehållsanalys. Resultat: Två kategorier framkommer ur resultatet. Svårigheter sjuksköterskor står inför och sjuksköterskornas sätt att hantera svårigheter. I första kategorin finns en subkategori sjuksköterskornas svårigheter i mötet med patienter med annan etnisk och kulturell bakgrund. I andra kategorin sjuksköterskornas sätt att hantera svårigheter finns fyra subkategorier hjälp av tolk, anhörigas hjälp, hjälp av kollegor och andra sätt att kommunicera. Diskussion: Språkbarriären var det främsta svårigheten som beskrevs i mötet och hur sjuksköterskor hanterade svårigheten i mötet med hjälp av tolk, anhöriga, kolleger och andra sätt att kommunicera. / Background: In this study, defined ethnicity as a collective term for origin while culture is socially enrolled into the character of one’s behavior and is changeable in context. In the literature it is clear that patients with a different ethnical and cultural background are subject to objectification by healthcare professionals. The individual in many cases is seen as a representative of his or her cultural and ethnical inherence. In Sweden there are many people with different ethnic and cultural backgrounds. People who emigrate affected by mental illness to a greater degree than the average population they are at greater risk for stress, worry and anxiety. Aim: The purpose of this study is to describe the specialist nurses' encounter with patients with different ethnic and cultural backgrounds and cared for mental illness. Methods: Data was collected through interviews with five specialist nurses. This study uses qualitative content analysis. Results: Two categories emerge from the results. Difficulties nurses face and the nurses' way of handling difficulties. The first category is a sub category of nursing difficulties in meeting with patients of different ethnic and cultural backgrounds. In the second category of nursing ways to handle difficulties are four subcategories help of an interpreter, relatives help, the help of colleagues and other ways to communicate. Discussions: The language barrier was the main difficulty which was described in the meeting and how the nurses dealt with the difficulty of the encounter with the aid of an interpreter, relatives, colleagues, and other ways to communicate.

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 present study, based on Lazarus' cognitive theory, identified coping strategies utilized by psychiatric nurses, and examined correlations between social support, perceived threat and coping effectiveness. The correlational design utilized a convenience sample of registered nurses holding membership in the Indiana State Nurses' Association Council on Psychiatric and Mental Health Nursing Practice. Subjects completed a demographic sheet, Interpersonal Support Evaluation List, Jalowiec Coping Scale, McNett Coping Effectiveness Questionnaire, and a one-item threat evaluation scale. Problem-focused coping was preferred by the sample. There was a statistically significant positive correlation between social support and coping effectiveness, a significant negative correlation between threat and coping effectiveness, and a non-significant negative correlation between social support and threat. Conclusions were psychiatric nurses utilize problem-focused coping strategies, there was a significant relationship betweeen social support and coping effectiveness, and threat and coping effectiveness, and a nonsignificant relationship between social support and threat. / School of Nursing

Tidigare vårdforskning inom psykiatrin har främst utgått ifrån personalens erfarenheter. Forskning har visat på ett behov att studera patienters erfarenheter. När det gäller unga vuxnas erfarenheter av psykiatrisk vård saknas forskning och det har därför varit intressant att studera det. Som teoretisk utgångspunkt har Barker och Buchanan-Barkers tidvattenmodell använts. Data samlades in via tre intervjuer som sedan analyserades med kvalitativ innehållsanalys. Syftet med studien var att belysa vad unga vuxna (18-24 år) beskriver som värdefullt i kommunikationen med sjuksköterskan. I analysen framkom tre kategorier samt ett tema. Kategorierna var betydelsen av personligt möte, att få vara delaktig och att få känna sig betydelsefull Temat som identifierades var att existera i ett sammanhang. Slutsatserna mynnade ut i fem viktiga frågor att tänka på för att etablera en god kommunikation med patienten. Ett område för fortsatt forskning skulle kunna vara att ta reda på hur sjusköterskor skulle kunna tillbringa mer tid med patienter. / Earlier research in the psychiatric field has primarily focused on the experiences of the staff. Research has shown that there is a need to study the experiences of the patients. When it comes to young adults experiences of psychiatric care there is a lack of research. Therefore it has been interesting to study that. The Tidal Model by Barker and Buchanan-Barker was used as a theoretical starting point. Data was collected from three interviews. The interviews where then analyzed with qualitative content analysis. The aim of this study was to highlight what young adults (18-24 years) described as valuable in nurse patient communication. The analysis gave three categories. They were the meaning of a personal meeting, to be involved and to feel important. The theme to exist in a context was identified. The final conclusions rendered five important questions to think of in order to establish a good communication with the patient. One area for further research could be to study how nurses could spend more time with patients.

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.

This study investigates the development of services and treatment modalities for the mentally ill of Western Australia from a nursing perspective. The thesis moves from the influences of Europe to focus on the emergence of services for the mentally ill in Western Australia. In particular the process of change that has occurred in the treatment of Western Australia’s mentally ill from colonisation to the end of the 1980s is considered. The study has a central focus on nursing care, and how nursing has adapted to changes in treatment modalities for mental illness as well as emerging government policy, fiscal restraint and community beliefs concerning mental illness. Through exploration of the role and care provided by mental health nurses and a description of the environment where this care was administered, an insight into how the mentally ill were perceived and treated is gained.

Aggression occurs frequently on many psychiatric wards; its assessment and management are crucial components of inpatient care. Consequences to inpatient aggression are profound, impacting on staff and patients, ward milieu and regime, and mental health services in general. Despite considerable research, which has primarily focussed on the assessment of demographic and clinical characteristics of aggressive patients, the nature of the relationship between mental illness, inpatient treatment and aggression remains unclear. Inconsistent risk assessment practices, management strategies and treatment plans, often derived from idiosyncratic beliefs about the causes of aggression, follow. Approaches to the assessment of inpatient aggression have been categorised as structural, which emphasise form, or functional, which emphasise purpose. Studies of inpatient aggression have primarily utilized a structural approach. These studies have resulted in the identification of demographic, clinical and situational characteristics of high-risk patients and environments. Resource allocation and actuarial assessments of risk have been assisted by this research. Conversely, functional assessment approaches seek to clarify the factors responsible for the development, expression and maintenance of inpatient aggression by examining predisposing characteristics, in addition to the proximal antecedents and consequences of aggressive behaviours. While functional analysis has demonstrated efficacy in assessing and prescribing interventions for other problem behaviours, and has been regarded a legitimate assessment approach for anger management problems, psychiatric inpatient aggression has been relatively neglected by functional analysis. Against this background, four studies focussing on the assessment of predisposing characteristics, precipitants and consequences, and purposes of aggressive behaviour, were undertaken to assist in the development of a functional analysis of psychiatric inpatient aggression. All four studies were conducted within the Thomas Embling Hospital (TEH), a secure forensic psychiatric hospital in Melbourne, Australia. The first of three initial studies involved a retrospective review of Incident Forms relating to aggressive behaviours that occurred within the first year of the hospital?s operation. The second involved a comparison of prospective assessment of aggressive behaviours with retrospective review of Incident Forms. The third involved a review of Incident Forms across two forensic psychiatric hospitals, the Rosanna Forensic Psychiatric Centre, and the TEH, to allow for the study of environmental contributors to aggression. The fourth, and main study, focussed on the assessment of patients and aggressive incidents, using a framework emphasising purpose, which was assessed using a classification system designed and validated as part of this study. Demographic and clinical information in addition to social behaviour, history of aggression and substance use were collected on the 204 patients admitted to the hospital during 2002. One hundred and ten of these patients completed an additional assessment of psychotic symptoms in addition to a battery of psychological tests measuring anger expression and control, assertiveness, and impulsivity. During 2002, the year under review, there were 502 incidents of verbal aggression, physical aggression, and property damage recorded. Staff members who observed these incidents were interviewed, and files were reviewed to record the severity, type, direction and purpose of aggression. Following 71 aggressive behaviours patients also participated in the assessment of purpose. Results from this, and the three initial studies, reinforced the contribution to aggression of a number of individual characteristics, including a recent history of substance use, an entrenched history of aggression, a recent history of antisocial behaviour, and symptoms of psychosis, including thought disturbance, auditory hallucinations and conceptual disorganisation. Somewhat surprisingly, a number of other characteristics shown through previous research to have a relationship with aggression, including anger arousal and control, impulsivity, and assertiveness did not show a relationship with aggression. Further, and perhaps a consequence of the peculiar characteristics of some patients admitted to the TEH, older patients and females were more likely to be repeatedly aggressive, yet neither age nor gender differentiated aggressive from non-aggressive inpatients. In this study acts of inpatient aggression were usually precipitated by discernible events, or motivated by rational purposes. Rarely was aggression the consequence of a spontaneous manifestation of underlying psychopathology occurring in isolation from environmental precipitants. A number of proximal environmental factors, most particularly staff-patient interactions associated with treatment or maintenance of ward regime, that were considered provocative or that threatened status, were evident in incidents of aggression perpetrated against staff. The perception of provocation and the need to enhance status were common precipitants of aggression between patients. There was little evidence to suggest that aggression was used instrumentally to obtain tangible items, to reduce social isolation, or to observe the suffering of others in the absence of provocation. Results of these four studies have implications for the prediction and prevention of inpatient aggression, and for the treatment of aggressive inpatients. These are discussed, as are the limitations of this research and suggestions for further research. / thesis (BPsychology(Hons))--University of South Australia, 2004.