M.Cur. (Psychiatric Nursing) / A diagnosis of cancer causes certain fears to arise in a patient, as well as among his family, activating intense emotional responses in everyone concerned. Examples of such emotions are anger. self-reproach, gUilt, heartache, helplessness and mourning. An acceptance of the circumstances does not necessarily occur, and the phases of the mourning process may be continually interchanging. As a result of all these emotions experienced by the patient with cancer as well as his family, mental discomfort is likely to occur. The family has to adapt its usual mechanism for handling internal discomfort, in order to include the pressure and demands to which they will be exposed as a result of the cancer and treatment thereof. Family cohesion will not necessarily be advanced as a result of this heightened pressure, and additional pressure may be placed on relationships within the family. Members of a family often find it difficult to discuss openly their fears, worries and feelings. for the simple reason that they are scared of becoming upset themselves, or alternately upsetting the rest of the family. Holding themselves back in this way may lead to a feeling of being isolated, which in turn leads to feelings of uncertainty being experienced. In this way the members of a family may find themselves becoming less and less involved with each other and with the patient's treatment, all as a result of not being able to talk about their fears and other intense emotions and therefore not being able to realise all these feelings. As a result of the family's uncertainty concerning their handling of the situation, they experience a loss of control and a change in their ability to handle their situation. These factors contribute to their experience of mental discomfort. Mental discomfort is not visible to others, therefore it is very rarely treated by the multiprofessional team. If the members of the team notice the existence of such discomfort, they will still emphasise the medical treatment, since they themselves may be uncertain as to any effective treatment for such a family. The registered nurse who is in continuous contact with the patient and his family, therefore has the challenge to support the family who suffers from mental discomfort in order to lessen their suffering and facilitate their striving towards achieving wholeness once more, whether in hospital, at home or in a community centre. There are several methods of interaction available for the treatment of such a family. Mental discomfort can be reduced by psychiatric nursing accompaniment. The purpose of this study was to explore and describe the folloWing: the contribution made by psychiatric nursing accompaniment through the medium of a psychiatric nursing specialist, as regards lessening the mental discomfort of the family of a patient being treated in an oncology unit or at home. A further purpose was to set certain guidelines for the registered nurse, concerning her support of the family of a patient in an oncology unit or at home, thereby lessening their mental discomfort. An exploratory, descriptive, contextual study was done on a family with one member who has been diagnosed with cancer, and who received treatment in an oncological unit and at home. This family submitted themselves to psychiatric nursing accompaniment. A purposive, non-selective sample was used and the family had to satisfy certain specific criteria pertaining to mental discomfort...

Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.

Abstract The aim was to describe the narratives unfolding in cooperative team meetings in acute psychiatric care. The cooperative team meeting is based on cooperative care, in which power and responsibility are shared between the participants. The participants in cooperative team meeting are the patient, her/his significant others and health care professionals. The aim of these meetings is defined based on the patient's need for care. The purpose of the study was to produce new knowledge about cooperative team meetings in psychiatric care. The results can be used to develop psychiatric care and the processes of learning and studying to nurse. The study approach was narrative, and it was focused on narratives in the cooperative team storytelling process. The data consisted of 11 videotaped cooperative team meeting in two acute psychiatric wards. The participants in each case consisted of a voluntary patient, his/her significant others, primary physicians, nurses and other experts. The research was a process. The spoken narratives in cooperative team meetings were approached using the methods of "Categorical-Content" reading and dialogue analysis based on a narrative approach. The unspoken narratives were unfolded using the QRS NVivo computer program and the "Holistic-Content" reading method. In the first phase, the silent narrative "shame" was found. In the second phase, the narratives "active" and "passive participation" based on cooperative care were found. In the third phase, the spoken and unspoken combined narrative "Shared-rhythm cooperation" was found. According to the results, the cooperative team meeting consisted of unspoken narratives. The cooperative team meeting was based on cooperative care if the participants defined and shared the topic of discussion and had eye contact and the authoritarian participant gave space for expression. The cooperative team meetings required open-ended and reasonable questions by the health care professionals. Furthermore, the interpretation was to be based on the patient's or the significant other's narratives and the meanings the events had had for them. The participants were able to introduce their narratives to the storytelling process if they had enough time. Shared understanding was possible if all participants' narratives were in interaction with each other. The cooperative team meeting was expert-initiative, if the storytelling was based on the professionals' narratives. The expert-initiative storytelling consisted of control, monologue, unreadable faces and immobility. The main goal was to elicit information of the patient, and the role of the patient and his/her significant others was to be a passive recipient. / Tiivistelmä Tutkimuksessa kuvataan psykiatrisen yhteistyöneuvottelun keskustelussa rakentuvia kertomuksia. Yhteistyöneuvottelu perustuu yhteistoiminnallisen hoidon lähtökohtiin, jossa valta ja vastuu ovat jaettu siihen osallistuvien kesken. Siten yhteistyöneuvottelu on psykiatrisen potilaan, hänen määrittelemiensä läheisten ja hänen hoitoonsa osallistuvien asiantuntijoiden potilaan tilanteeseen perustuva tapaaminen. Tutkimuksessa on tuotettu uutta tietoa yhteistoiminnallisesta yhteistyöneuvottelusta psykiatrisessa hoidossa. Tulosten perustella voidaan kehittää hoitotyön käytäntöä ja koulutusta. Tutkimuksen lähestymistapa oli narratiivinen ja tutkimuksen kohteena oli yhteistyöneuvottelun kertomistilanteessa rakentuvat kertomukset. Tutkimusaineisto muodostui 11 videoidusta yhteistyöneuvottelusta kahdelta psykiatriselta akuuttiosastolta. Näihin yhteistyöneuvotteluihin osallistuvat olivat vapaaehtoisia potilaita, hänen nimeämiään läheisiä, lääkäreitä, hoitajia ja muita asiantuntijoita. Tutkimus eteni prosessina. Yhteistyöneuvottelun sanallisia kertomuksia rakennettiin narratiivisella "Categorical-Content" - ja dialogianalyysi lukutavoilla. Sanattomia kertomuksia rakennettiin QRS NVivo-tietokoneohjelmalla ja " Holistic-Content"- lukutavalla. Prosessin ensimmäisessä vaiheessa löydettiin yhteistyöneuvottelun kertomaton kertomus "häpeä". Prosessin toisessa vaiheessa rakentui yhteistoiminnallisuutta kuvaavat "aktiivinen-" ja "passiivinen osallistuja"- kertomukset. Kolmannessa vaiheessa rakentui sanallisen ja sanattoman kertomisen yhdistävä "jaettu rytminen yhteistyö"-kertomus. Tulosten mukaan psykiatrinen yhteistyöneuvottelu sisälsi kertomatonta kertomusta. Psykiatrinen yhteistyöneuvottelu oli yhteistoiminnallista, jos siihen osallistujat määrittelivät ja jakoivat yhteisen kertomisen kohteen, osallistujilla oli katsekontakti ja auktoriteetti antoi tasapuolisesti tilaa kaikille osallistujille. Yhteistoiminnallisuus edellytti asiantuntijoilta avoimia ja perusteltuja kysymyksiä. Lisäksi se edellytti, että asiantuntija vahvisti kertomisen seurauksena syntyvän tulkinnan potilaalta. Yhteistoiminnallinen hoito edellytti myös aikaa, jotta kaikki voivat tuoda näkökulmansa yhteisen kertomuksen rakentamiseen. Jaettu ymmärrys potilaan tilanteesta mahdollistui, jos kaikkien osallistujien kertomukset olivat vuorovaikutuksessa keskenään. Psykiatrinen yhteistyöneuvottelu oli asiantuntijalähtöistä, jos yhteistyöneuvottelun sisältöä rakennettiin asiantuntijoiden kertomuksista ja asiantuntijat pitäytyivät omissa kertomuksissaan. Asiantuntijalähtöinen kertominen sisälsi kontrollointia, monologia, ilmeettömyyttä ja eleettömyyttä. Asiantuntijalähtöisen kertomuksen pääpaino oli tietojen keruussa, tällöin potilaan ja hänen läheisensä tehtävänä oli tiedon antaminen.

M.Cur. (Psychiatric Nursing) / The objectives of this study were to describe group nursing therapy as a resource utilized by the psychiatric nurse as a way of facilitating the adolescent's mobilization of resources to cope with the violence in their everyday life and to describe guidelines for group nursing therapy to facilitate the promotion, maintenance and restoration of these adolescent's mental health. The situation of violence makes the adolescent susceptible to mental health problems. The adolescent perceive various degrees of violence in their homes, the community and at school. A combination of these violence related situations predisposes the adolescents to developing unhealthy ways of coping with the effects of violence. The number of adolescents referred to psychiatric community services has increased at an alarming rate. The main reasons for their referral was their poor scholastic performance; they were generally labelled as "a lost generation" and also as being mentally ill. The research was based on Nursing for the Whole Person Theory and the functional approach to nursing research was assumed. This implies that the goal of the research was aimed at improving the quality of patient care. The research design was descriptive and qualitative in nature, which was also contextual. The descriptive single case study method was utilized. Reliability was ensured by using as many steps as possible to operationalize the case study - and the research was conducted as if someone were always looking over the researcher's shoulder. Validity control measures were applied to counteract criticism by ensuring that a sufficient operational set of measures was developed and objective judgements were used to collect data by way of coding transcribed audiotaped material from all the sessions of the group nursing therapy...

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

D.Cur. / There is currently lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services of the Gauteng Province. This lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services, is associated with her supervisors who are the psychiatric nurse managers. The purpose of this research was to develop and describe a model that could be implemented to guide the mobilization of the advanced psychiatric nurse as a resource person in the mental health services in order to facilitate her mental health. The research also focused on developing guidelines for the implementation of the model for the mobilization of the advanced psychiatric nurse as a resource person. The model: "Mobilization of the advanced psychiatric nurse as a resource person: an interactive process", together with its operational guidelines was developed by using a theory generative design, that is, qualitative, explorative, descriptive and contextual in nature. This model was developed according to Chinn and Kramer's (1995) approach to theory generation, namely: identification of the central concepts for the model by conducting a field study to explore and describe the views of the advanced psychiatric nurse and those of the psychiatric nurse managers with regard to the mobilization of the advanced psychiatric nurse as a resource person in the mental health services of Gauteng; analysing the data gathered through focus groups interviews from the sample of the advanced psychiatric nurses and form the sample of psychiatric nurse managers using Strauss and Corbin's (1990) open, axial, and selective coding approach to guide data analysis; analysing the data by identifying, defining, classifying the concepts and placing them into relationship with each other to form relationship statements as the conceptual framework for the model; describing the model using strategies proposed by Chinn and Kramer (1995) and then subjecting the model to evaluation by experts in theory generation; describing the guidelines for the implementation of the model in the clinical setting.

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

D.Cur. / South Africa, like many other countries, is charged with ensuring that her adolescents are mobilised to believe in the power of their own dignity in order for their life-world to change. Hundreds of thousands of adolescents were forced to experience political upheavals, violence, neglect, incarceration and family disorganisation. Many of these adolescents were forced onto the margins of society in their strive for understanding and survival. Many dropped out of school, are unskilled and therefore unemployed. They feel hopeless as they struggle for a place in society, because society has no faith in them - "they are lost to society". The purpose of this study was to generate a psychiatric nursing model to facilitate the reintegration of marginalised adolescents into the community. This study therefore has profound social, political and economic implications for the South African community. Through this model, which is a theoretical framework to be utilized by the advanced practitioner in psychiatric nursing, adolescents will be empowered to believe in themselves, to engage in meaningful relationships and activities with their families, peer groups and the broader community. The model provides a theoretical framework that attempts to rekindle and inspire the adolescents from a state of hopelessness and disillusionment, to integrated individuals who are respected, valued and accepted as integral members of their families, peer groups and communities. The model will assume a problem solving and preventative approach. Based on this discussion, the following questions were addressed in this research: What obstacles exist that hamper marginalised adolescents' reintegration into the community? What could be done to assist marginalised adolescents' reintegration into the community? A theory generative, qualitative, contextual, exploratory and descriptive design was followed. The research was conducted in four steps with a pilot-study that preceded step one of the research. In step one, focus group discussions were conducted with five groups of respondents to explore and describe obstacles that hamper the reintegration of marginalised adolescents into the community, as well as their views on how marginalised adolescents can be assisted to be reintegrated into the community. Data was analysed using Tesch's method. Based on the results of analyzed data, disempowerment, characterized by hopelessness, alienation/isolation, anger, frustration and worthlessness - related to poor socialisation, lack of support and services, family disorganisation, peer pressure and fragmented services - was identified as a main theme among stumbling blocks. Empowerment, characterized by improved self-image, feelings of worth, belief in own dignity - related to a sense of wellbeing, belonging and respect - resulting in personal growth and societal change with ultimate reintegration, was identified as major strategy to address marginalisation. In step two, the defined concepts were related to each other to show interrelationships. Classification of central and relational concepts followed to formulate relationship-statements, the result being to depict related concepts in structural form. In step three, a visual model to be utilized as a theoretical framework by the advanced psychiatric nurse practitioner to facilitate the marginalised adolescents as recipients and the advanced psychiatric nurse as agent, was designed to facilitate reintegration into the community. The model was evaluated by a panel of experts. Step four dealt with guidelines to operationalise the model in practice, education and research. Recommendations and limitations of the research were also discussed.

Orientador: Wilza Carla Spiri / Resumo: Objetivo: Compreender o significado do uso dos sistemas de classificação de pacientes como ferramenta gerencial para os gestores de enfermagem psiquiátrica e avaliar as características psicométricas do Sistema de Classificação de Pacientes Psiquiátricos – versão 2. Método: Estudo multimétodo sendo o delineamento qualitativo para a compreensão do significado, coleta de dados por meio de entrevistas semiestruturadas áudio gravadas e referencial metodológico da Análise de Conteúdo, já o delineamento de estudo metodológico foi utilizado para avaliar as características psicométricas através da Técnica Delphi com análise estatística. Participaram 10 gerentes de enfermagem de instituições psiquiátricas do Estado de São Paulo e 60 juízes especialistas. Utilizou-se o software NVivo para auxílio na análise das entrevistas e opiniões dos juízes e o software R Core Team para a análise estatística. A coleta de dados foi realizada entre agosto/2016 e maio/2017. Resultados: Quanto aos gerentes, a amostra constituiu-se de nove mulheres e um homem, com 14 anos de experiência em saúde mental e que estavam há quase sete anos no referido cargo na atual instituição. O ambiente do cuidado psiquiátrico emergiu como tema geral cercado por quatro subtemas: modelo atual de tomada de decisão, modelo ideal de tomada de decisão, dimensionamento de enfermagem, legislação profissional e de saúde mental. Apenas metade dos gerentes utilizaram um sistema de classificação de pacientes como ferramenta gerencial... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Objective: To understand the meaning of using patient classification systems as a managerial tool for psychiatric nursing managers and to evaluate the psychometric characteristics of the Psychiatric Patient Classification System - version 2. Method: Multi-method study used or qualitative quality design of the meaning, data collection through recorded semi-structured audio interviews and methodological references of Content Analysis, already outlining methodological studies used to evaluate how psychometric characteristics applied by the Delphi Technique with Statistical Analysis. Participated 10 managers of psychiatric nursing institutions in the State of São Paulo and 60 expert judges. The N-Vivo software was used to aid in the analysis of interviews and judges' opinions and the R Core Team software for statistical analysis. Data collection was carried out between August 2016 and May 2017. Results: As for the managers, a sample composed of nine women and one man, with 14 years of experience in mental health and who were almost seven years without a load at the current institution. The emerging psychiatric care environment as the general theme surrounded by four sub-themes: current decision model, ideal decision model, nursing dimension, professional legislation and mental health. Only half of the managers used a patient classification system as a management tool and as practices are still used without empiricism. As for the panel of judges, a sample composed of 14 documents,... (Complete abstract click electronic access below) / Doutor

Bakgrund: Självreflektion innebär att kunna iaktta sig själv, sina reaktioner och att kunnasamtala med sig själv om sina handlingar och om sina upplevelser. Det är ett medvetetsökande efter förståelse. Reflektion ger möjlighet att utveckla yrkesmässig medvetenhet omsitt eget sätt att fungera och reagera. Genom systematisk reflektion kan individen utvecklasoch koppla teori till praktik. Individen måste medvetet utvärdera sina erfarenheter för attkunna dra lärdom av dem. Syfte: Syftet var att belysa sjuksköterskors möjligheter till självreflektion inom psykiatriskvård. Metod: En integrativ litteraturstudie användes som metod. Data inhämtades från databasernaCinahl plus, PubMed och PsycINFO.Sammanlagt sex artiklar ligger till grund för resultat. Material har analyserats medWhittemore och Knafls (2005) analysmetod. Resultat: Sjuksköterskor behövde skapa utrymme för självreflektion. Studier visade attarbetsgivare behövde möjliggöra att självreflektion kunde utövas på arbetsplatsen ochmedarbetare måste värdesätta att självreflektion kunde fungera som ett hjälpmedel i denpsykiatriska omvårdnaden. Det var också viktigt att lärare och utbildare, i enutbildningssituation, var intresserade av individens lärande och hade kunskap om hur man lärut självreflektion. Slutsats: Möjligheter till självreflektion är tid, kunskap och en tillåtande miljö därsjuksköterskan eller sjuksköterskestudenten kan och vågar ställa frågor och där det finns engemensam norm som värdesätter självreflektion på arbetsplatsen. / Backgound: Self-reflection means being able to observe oneself, their reactions and beingable to talk to themselves about their actions and their experiences. It is a conscious search forunderstanding. Reflection provides the opportunity to develop professional awareness ofone ́s own way of functioning and reacting. Through systematic reflection, the individual candevelop and link theory to practice. The individual must consciously evaluate theirexperiences in order to learn from them. Aim: The purpose of this study is to elucidate nurses ́ opportunities for self-reflection inpsychiatric careMethod: An integrative literature study was used as a method. Data were obtained from thedatabases Cinahl Plus, PubMed and PSYCinfo. A total of six articles form the basis for theresult. The material has been analyzed using the Whittemore and Knafls (2005) method. Results: Nurses need to create space for self-reflection. The study showed that employersneeded to enable self-reflection to be exercised in the workplace and employees needed toappreciate that self-reflection could serve as an aid in psychiatric nursing. It was alsoeducators, in an educational situation, were interested in the individual ́s learning and hadknowledge of how to teach self-reflection. Conclusion: Opportunities for self-reflection are time, knowledge and a permissiveenvironment where the nurse or nurse student can and dare to ask questions and where there isa common norm that values self-reflection in the workplace.