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Thesis (M.S.)--Boston University

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Community Psychology in the Department of Psychology in the Faculty of Arts at the University of Zululand, 2006. / The present study investigated the role that is played by family members in helping psychiatric patients cope with their illnesses. Twenty-seven psychiatric patients participated in the study. Of these, eighteen had been admitted to the local hospital for various complaints, and had been referred to the psychologist for psychotherapy. Nine participants were seen during private consultation sessions with the author/researcher. A convenient sample was used in that the criterion for inclusion of participants in the sample was based on patients suffering from certain psychiatric illnesses for example mood disorders, psychotic disorders or anxiety disorders. A semi-structured questionnaire was used to collect data for the study. The questionnaire covered participants' biographical information, details about psychiatric patients' illness such as their initial reactions to the diagnosis, knowledge about the illness, the level of support they received from family members and the community and the perceived causes of the illness. The procedure for data collection involved directed conversations in which patients reflected on their experiences both in and out of the hospital, for example the level of support they received from the family and community members, and information about their psychiatric conditions after being discharged from hospital. In addition, family members were asked to express their feelings and perceptions about the patients' conditions including the challenges they encountered as a result of having a family member with a psychiatric illness. The results of the study were that many psychiatric patients reacted with shock, fear and confusion to their illness diagnosis. Many also appeared to have some knowledge of the illness, including the belief by some that they had been bewitched. Some of the patients were unemployed as a result of being mentally ill, and this led to financial strains in the family. The main finding of the study was that most psychiatric patients still continue to be discriminated against in the communities in which they live. Most family members, however, were found to be supportive to their mentally ill relative. Some of the challenges faced by family members included a lack of knowledge about the illnesses affecting their relatives. The results of the study are generally consistent with the findings by other investigators regarding the important role that is played by family members in helping their relatives cope with psychiatric illnesses. In addition the study highlighted an urgent need by the government to improve mental health services by, among other things, providing adequately qualified professionals who may facilitate the process of integrating mentally ill persons with their communities.

Thesis (M.S.)--Boston University

Thesis (Ed.D.)--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. / This study explored the effectiveness of community based services to chronic psychiatric patients in improving their quality of life. The exploration aimed at shedding light on the nature and extent of such quality of life improvements, and on which of the services such improvements depend. Certain general expectations guided this Study: (a) that community based therapeutic services offered in typical day treatment programs do have a positive effect on their patients' quality of life; (b) that the patients' own reports on the utility of the services and on their quality of life provide valid data. There was limited prior research supporting either of these expectations. Therefore this Study dealt with validity as well as effectiveness issues. The Study limited itself to a single community based service system which is part of a community hospital. The day treatment services offered were found to conform to widely accepted norms. Therefore the results of the Study were generalizable to some degree. Quality of life data were collected from patients, before and after treatment, using a quality-of-life questionnaire which has a published record of previous use. Two other types of data were collected: service utility evaluations by patients, and patient improvement evaluations by their therapists. This was accomplished with questionnaires designed as part of this Study. It was found that before to after treatment changes in patients' quality of life reports were significantly correlated with their evaluations of service utilities, giving support to the validity of both types of data. The exploration also provided evidence for the existence of specific sources of error --such as the patients' tendency towards emotional fluctuations due to their pathology. Validity of the therapists' evaluations of patient improve-ment was not supported. Comparisons with a control group combined with the previously mentioned cor-relations provided exploratory evidence for the effectiveness of the day treatment program. The areas of the patients' lives most affected were family and social relations. All aspects of the program seemed to combine in producing improvement. / 2031-01-01

MPH, Faculty of Health Sciences, University of the Witwatersrand, 2011 / Background: General public hospitals in South Africa are currently overloaded with psychiatric patients who cannot be transferred to specialised psychiatric hospitals because of lack of beds. Identification of factors influencing bed occupancy could be used to model ideal referral systems for psychiatric patients. There has been no known study conducted in the specialised psychiatric hospitals in South Africa to assess patient profiles since the implementation of the Mental Health Care Act of 2002. This study was planned to determine the length of stay in a psychiatric hospital in Gauteng Province and to identify factors that could influence the length of stay in that hospital. Aims: To determine the length of stay in specialty units and the influence of specific factors on length of stay at the Tara - the H Moross Centre, during a one-year period. Methodology: This was a cross sectional study which involved the analysis of retrospective data for a one-year period. This data is routinely collected by the Hospital. Variables included age, gender, ethnicity, marital status, employment status, medical aid utilisation, education level, hospital classification, unit of admission, access to hospital, source of referral, season, frequency of admissions, medico-legal status, and length of stay. Descriptive statistics was used to analyse the data. Permission was obtained from the Gauteng Department of Health and Social Development, and the University of the Witwatersrand Ethics and Postgraduate Committees. Results: The findings indicate that most patients stay in Tara for 49 (29-78) days, which is in keeping with the expectation of this hospital, which is an acute to medium term psychiatric hospital. Significant differences in gender, ethnicity, marital status, employment status, medical AID status and hospital classification among different wards was established. The clinical profile was predominantly biochemical related disorders from public tertiary and public secondary hospitals reflecting the under privileged groups in the population. Social demographic factors and clinical profiles were found to significantly influence the LOS. Gender, ethnicity, employment status, and source of referral were more influential. Conclusion: A follow up study could look at the readmission rates of these patients who stay in the hospital for this short period to determine if the rehabilitation programmes are indeed effective or the patients are being discharged prematurely only to be readmitted.

Complementary and alternative medicine (CAM) is distinct from orthodox western medicine. In the modern time¡Adue to chronic disease increase year by year and the consumer¡¦s concept of health is not merely without disease. These had changed the people¡¦s seeking medical help behavior. Western medicine in controlling and treating of acute disease had achieved remarkable results, but of chronic disease is disappointed due to chemical drugs long tern side effects. Complementary and alternative medicine relative to western medicine is more nature and modest without severe side effect. In many studies , people utilization of CAM as medical treatment increase year by year. In this study , I will explore the using conditions and degrees of CAM of patients in chronic psychiatric ward. We purposely select the patients and under the informed consensus of patient we apply questionnaires to them. After collecting the questionnaires, we perform statistic analysis. According to statistic results, we discuss the clinical meaning and hope to offer some valuable informations to mental heath providers.

In this thesis, Giddens' theory of structuration is employed in an analysis of the ghetto of ex-psychiatric patients in Hamilton, Ontario. A review of the main concepts of of structuration theory forms the basis for a theoretical model of the structuration of urban space that considers both the individual agent and the social system as equal partners in the production and reproduction of the urban built environment. From this general model, methodologies are developed for institutional analysis and an analysis of strategic conduct. The institutional analysis enables an understanding of the ghetto as the unintended outcome of deinstitutionalization policy. An examination of the city of Hamilton's attempt to dismantle the ghetto focuses on the strategic conduct of the actors in the policy-making process, and provides insight as to why the city's attempt has thus far proved unsuccessful in halting the ghettoization of ex-patients. The study demonstrates the theoretical and empirical utility of structuration theory in providing an analysis that considers the complex interrelationships of system, structure, agency, time and space. / Thesis / Master of Arts (MA)

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The aim of this descriptive survey was to investigate the attitudes of mental health care providers with regards to the management of aggression and violence. The absence of scientific data describing the attitudes of nurses towards the management of aggression and violence motivated the researcher to conduct this study. The researcher undertook a descriptive survey to describe the attitudes of nurses towards the management of aggression and violence. The management of aggression and violence attitude scale (MAVAS) was administered to N92 nurses with different qualifications these nurses are employed in the acute admission units of four psychiatric hospitals in a province in South Africa. The results showed no significant differences in attitudes between the different categories of nurses in most of the questions. Enough evidence was gathered that indicated, compared to trained staff, staff without a qualification in psychiatric nursing science had found it difficult to calm patients down, had not understood the effect of the environment on a patient, had felt that patients should control their feelings and had lacked the perception of trained nurses, with regards to the effect of negotiation and poor communication on violent and aggressive mental healthcare users. These findings can make significant contributions towards the implementation of training programmes and policies to assist staff to deal with patient related aggression and violence. Furthermore the data generated can contribute towards future research in this field with subsequent expansion of skills programmes. / AFRIKAANSE OPSOMMING: Die doelstelling van hierdie navorsings studie was om die houding van psigiatriese gesondheidsdiens voorsieners ten opsigte van die hantering van aggresie en geweld te bepaal. Die afwesigheid van wetenskaplik gefundeerde data het die navorser genoop om hierdie studie te onderneem. Die navorser het derhalwe ʼn beskrywende studie gedoen om die houding van verpleegsters ten opsigte van die hantering van aggressie en geweld te bepaal. Die “management of aggression and violence attitude scale” (MAVAS) is deur N92 verpleegsters met verskillende kwalifikasies voltooi. Hierdie verpleegsters is indiens van vier verskillende psigiatriese hospitale in ʼn provinsie in Suid- Afrika. Die verpleegsters werk in die akute opname eenhede van die onderskeie hospitale. Die resultate het geen noemenswaardige verskille tussen die onderskeie kategorieë verpleegsters se houding teenoor die hantering van aggressie en eweld aangedui nie. Genoegsame bewys is ingesamel wat aandui; dat in vergelyking met opgeleide personeel, personeel sonder ʼn kwalifikasie in psigiatriese verpleeg wetenskappe, dit moeiliker vind om pasiënte te kalmeer, nie verstaan watter effek die omgewing op ʼn pasiënt het nie. Dié kategorieë voel pasiënte moet hul gevoellens beheer en het ook nie dieselfde persepsie ten opsigte van die effek van onderhandeling en swak kommunikasie op aggressiewe en geweldadige psigiatriese gesondheids diens verbruikers as hul kollegas nie. Hierdie bevindings is ʼn belangrike bydrae ten opsigte van die implementering van opleidings programme en beleid ten einde personeel te ondersteun om pasiënt verwante aggressie en geweld te hanteer. Die nuwe data gegenereer deur dié navorsings studie kan bydra tot toekomstige navorsing in hierdie veld asook gevolglike uitbreiding van vaardigheids programme.

Psykisk ohälsa är ett växande problem i samhället och allmänsjuksköterskan möter i sitt arbete dagligen människor med psykisk ohälsa. Dessa människor upplever sig ofta osynliga i samhället och upplever även förutfattade meningar i mötet med sjuksköterskan. Forskning idag utgår mindre ofta från perspektivet hos människor med psykisk ohälsa, vilket behövs för att omvårdnaden ska kunna utvecklas. Problematiken är att sjuksköterskan många gånger möter människor utifrån deras psykiska diagnos, istället för att möta dessa människor utifrån ett helhetsperspektiv. Examensarbetet beskriver hur vuxna människor med psykisk ohälsa kan uppleva mötet med sjuksköterskan. Två teman framkommer efter sammanställning av befintlig forskning. Vuxna människor med psykisk ohälsa upplever antingen sig sedda i mötet med sjuksköterskan eller en känsla av osynlighet. Känslan av att vara sedd uppkommer när sjuksköterskan bekräftar individen genom att vara öppensinnad. Sjuksköterskan lägger ner tid i mötet genom att lyssna och att försöka förstå personens situation. En känsla av osynlighet i mötet uppkommer när sjuksköterskan förminskar personen till en diagnos. De med psykisk ohälsa upplever hinder i relationen genom att sjuksköterskan utövar makt och behandlar dem som barn. De känner sig ensamma när sjuksköterskan inte har tid för dem och inte tyckts bryr sig om dem. Genom denna studie kan sjuksköterskan få en ökad förståelse för hur vuxna människor med psykisk ohälsa upplever mötet med dem. Ökad förståelse kan förbättra relationen mellan människor med psykisk ohälsa och sjuksköterskan. Det kan även leda till en ökad känsla av hälsa hos människor med psykisk ohälsa. / Background: Mental illness has in recent years increased in society. It has since centuries been seen as a shameful disease and mental illness has not been a high priority in health care. Aim: The aim of this study was to describe how adult humans with mental illness experiences the meeting with the nurse.Method: The method that was used was a literature based study with basis in analysis of qualitative research. 11 articles with a qualitative approach was analyzed. Result: The result showed two main theme. The first theme was a feeling of being seen in the meeting when an open dialogue was used and a relationship was created. The second theme was a feeling of invisible because they felt reduced to a diagnosis and encountered obstacles in the relation. Conclusion: Adult humans with mental illness could experience the meeting in different ways. A good meeting with the nurse could increase the human with mental illness trust in healthcare. It could improve the care and relationship between human with mental illness and the nurse.