Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

The thesis is organised around an empirical investigation of the relationship between residents of a Hertfordshire village and people who are, or who have been, patients at a nearby psychiatric hospital, some of whom regularly venture into the village to use local facilities. The research employs the method of participant observation and draws upon the discourse analytic approach of Potter and Wetherell, together with the rhetorical perspective of Michael Billig. In particular, the research focuses upon the discursive practices of local people, practices which function to sustain, amplify or minimise difference between themselves and others who are patients. The critical theory of Jürgen Habermas is drawn upon to complement and extend the discourse analysis approach, which receives critical evaluation. In addition, the time-geography of Alan Pred is employed as an heuristic for the representation of journeys of patients in the village. The historical dimension of the relationship between village and hospital is addressed by drawing upon Parish Council minutes and local newspaper reports. The thesis contains a conceptual investigation of public anxieties concerning mental disorder, an overview and discussion of the contemporary relevance of the labelling perspective, and a review of relevant literature. In addition it provides an exploration of methodological and textual issues.

Närstående betraktas tillsammans med patienten att vara experter i patienternas livsomständigheter. Ett gott samarbete mellan psykiatrisjuksköterskan och närstående kan innebära flera fördelar för patienters mående. För att uppnå förbättrad samarbete med närstående är det av betydelse att få ta del av psykiatrisjuksköterskors erfarenheter av samarbete med närstående. Syfte: Syftet med pilotstudien var att belysa psykiatrisjuksköterskors erfarenheter av samarbete med närstående i psykiatrisk vård. Metod: Studien har en kvalitativ ansats. Data baseras på fyra intervjuer med psykiatrisjuksköterskor utifrån öppna frågor. Data har analyserats med kvalitativ innehållsanalys. Resultat: Studien resulterade i kategorierna: Möjligheter till samarbete, Ett väl fungerande samarbete och Utmaning till samarbete. Konklusion: Psykiatrisjuksköterskorna hade intresse för samarbete med närstående i psykiatrisk vård. Samarbete sågs som positivt i patientarbetet men var inte alltid möjligt att praktisera. Samarbete upplevdes underlätta patientarbetet och leda till förbättrad relation mellan närstående och patienten. Det fanns flera svårigheter som utgjordes som hinder till samarbete. För kvalitétsbättring krävs att verksamheten ger stöd i kompetenshöjning och har ett förhållningssätt som är riktad till samarbete med närstående. Resultatet kan ha betydelse i förbättringssyfte för att utveckla ett fungerande samarbete med närstående till patienter i den psykiatriska vården. / Family members and next of kin are a central and natural partner who, together with the patient, constitutes the most important experts in their life circumstances. Collaboration with family members may include prevention of illness, acceleration of recovery, shorter care time and fewer incisions for the relative with mental illness. Only a few studies describe the professionals´ perspective on collaboration with family members. Aim: The aim of the pilot study was to describe the psychiatric nurse's experiences of collaboration with family members in psychiatric care. Method: The study has a qualitative approach and data was based on four interviews with psychiatric nurses based on open questions. Data has been analyzed with qualitative content analysis. Result: The study resulted in the categories: Opportunities for collaboration, Experiences of working collaboration and Experiences of challenge for collaboration. Conclusion: Psychiatric nurses had an interest in collaboration with family members in psychiatric care. Collaboration was considered positive in patient work but was not always possible to practice. Collaboration was found to facilitate patient work and lead to improved relationships between family members and patient. There were several difficulties that constituted interference to collaboration. It requires that the psychiatric care unit provide support in raising competence and has an attitude aimed at collaboration with family members for quality improvement. The result may be important for improvement purposes in order to develop effective collaborative relationships with family members in psychiatric care.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / A nova forma de cuidar em saÃde mental, com Ãnfase nos serviÃos comunitÃrios, possibilitou Ãs famÃlias a convivÃncia com a pessoa com transtorno mental e as reconhecem como a principal provedora de cuidados. Esse novo contexto deve ser referÃncia para estudos e debates na Ãrea acadÃmica e social para direcionar a tomada de decisÃes na assistÃncia prestada aos cuidadores, frente aos encargos atribuÃdos a esta funÃÃo e a possÃvel sobrecarga. Esse estudo teve como objetivo analisar o grau de sobrecarga objetiva e subjetiva sentida por cuidadores familiares de pacientes assistidos pelo Centro de AtenÃÃo Psicossocial Geral (CAPS Geral), Centro de AtenÃÃo Psicossocial Ãlcool e Drogas (CAPS AD) e em Unidade de InternaÃÃo PsiquiÃtrica em Hospital Geral (UIPHG) no MunicÃpio de Sobral, CearÃ, discutindo as diferenÃas estatisticamente significativas. Adotou-se a metodologia quantitativa, transversal, de carÃter exploratÃrio e descritivo, os quais participaram 385 cuidadores, sendo 216 no CAPS Geral, 86 no CAPS AD e 83 cuidadores na UIPHG. Realizou-se uma entrevista estruturada, aplicando um questionÃrio sociodemogrÃfico e a Escala de AvaliaÃÃo da Sobrecarga dos Familiares (FBIS-BR). Foram utilizados os softwares EXCEL e SPSS para organizaÃÃo e anÃlise estatÃstica dos dados, sendo adotado o nÃvel de significÃncia de 5%. Os resultados mostraram que nos trÃs grupos, as atividades realizadas com maior frequÃncia pelos cuidadores familiares relacionaram-se Ãs tarefas cotidianas de assistÃncia ao paciente e as que geraram maior incÃmodo foram as de supervisÃo dos comportamentos problemÃticos desses pacientes. O grau de sobrecarga global objetiva foi maior no grupo de cuidadores na UIPHG. Na anÃlise das subescalas objetivas, este grupo apresentou maior sobrecarga com relaÃÃo à supervisÃo aos comportamentos problemÃticos e no impacto nas rotinas diÃrias. Entretanto, o grupo de cuidadores no CAPS Geral apresentou maior sobrecarga objetiva com relaÃÃo à assistÃncia na vida cotidiana. NÃo houve diferenÃa entre os grupos de cuidadores referente à sobrecarga global subjetiva; porÃm, ao analisar as subescalas individualmente, o grupo na UIPHG se sentiu mais incomodado ao supervisionar os comportamentos problemÃticos e mais preocupado com o futuro e o tipo de ajuda e tratamento mÃdico do paciente. VariÃveis como o sexo e a idade estiveram associadas à sobrecarga. Estes resultados apontam que os profissionais devem repensar estratÃgias de apoio e intervenÃÃo para a assistÃncia adequada Ãs necessidades das famÃlias em cada serviÃo de saÃde mental. / The new form of taking care in mental health with emphasis on community service has allowed families to live with mental patients and recognize themselves as their main care providers. This new context should be reference for studies and debates in the academic and social areas to guide decision-making in the caregiversâ assistance, due to the tasks assigned to this role and the possible overload. The purpose of this study was to analyze the degree of objective and subjective overload felt by family caregivers of patients treated by the Geral Psychosocial Care Center (CAPS Geral), Psychosocial Care Center Alcohol and Drugs (CAPS AD) and in an Inpatient Psychiatric Unit in a General Hospital (UIPHG) in the city of Sobral, CearÃ, discussing the statistically significant differences. Adopted the quantitative methodology, cross-sectional, exploratory and descriptive, which included 385 caregivers, 216 of the CAPS Geral, 86 from CAPS AD and 83 caregivers of UIPHG. A structured interview was conducted out by applying a sociodemographic questionnaire and the Family Burden Interview Schedule (FBISâBR). It was used EXCEL and SPSS software for organizing and analyzing statistical data. The level of significance was 5%. The results showed that the three groups, the activities held more frequently by family caregivers related to the daily tasks of patient care and producing more disturbing were the supervision of problematic behaviors of these patients. The degree of objective global burden was higher in the group of caregivers from the UIPHG. In the analysis of objective subscales, this group showed higher overload concerning the supervision of difficult behaviors and the impact on daily routines. However, the group of caregivers of CAPS Geral presented more objective overload concerning care in everyday life. There was no difference between groups of caregivers regarding the subjective global overload. However, when analyzing the subscales individually, the group in UIPHG felt more bothered by observing the problematic behaviors and more concerned about the future and the type of aid and medical treatment of the patient. Variables such as sex and age were associated with overload. These results indicate that professionals must rethink strategies of support and intervention for the appropriate assistance the needs of families in each mental health service.

Magister Curationis - MCur / Unlawful absence of patients from the acute psychiatric ward increases concern on the part of the professionals responsible for their care. Patients who abscond from psychiatric hospitals represent a risk of potential harm to patients or the general public. Consequences of absconding may include physical harm and prolonged treatment time, as well as considerable economic cost to the family and government. The aim of the study was to explore and describe the nurse's experiences of assessment and management for patients at risk of absconding from an acute psychiatric ward in the Western Cape. A qualitative approach using an exploratory descriptive design was applied to conduct this study. The target population was mental health nurses working in acute psychiatric wards where patients were at risk of absconding. A sample of ten (n=10) mental health nurses was purposively selected to participate in the study. Semistructured interviews were used to collect the data from participants. Data collection continued until data saturation was reached (until no further new information emerged). Data was analysed manually by coding, categorizing and identifying similar patterns. Trustworthiness of the study was ensured through addressing the confirmability, transferability; credibility and dependability. Ethics approval was obtained from the University Research Ethics Committee and Ethics Committee of the Department of Health and the selected psychiatric hospital. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent were adhered to. Three themes emerged from the data: risk assessment, risk management, and increased observations. The results of the study was discussed with relevant recent literature evidence. The qualitative research is limited to few study sample size, and the results cannot be generalized to other similar population.

The hypotheses investigated were (1) as measured by a test of impulse control, elopers are more impulsive than non-elopers, and (2) as measured by a test of impulse control, males are more impulsive than females. The Self-Report Test of Impulse Control (STIC) and the Barratt Impulsiveness Scale (BIS) were administered to 76 female and 40 male patients at the time of admission to an open psychiatric hospital. Of these, 20 females and 10 males eloped. The first hypothesis was only partially supported. The second hypothesis was not supported. The BIS was found to be a potential predictor of elopers. The data also suggested that males elope later than females.

Die Arbeit befasst sich mit der Internetnutzung von psychiatrischen Patienten. Das Angebot an Therapien für Patienten mit psychiatrischen Erkrankungen steigt seit Jahren. Auch die Menge an Informationen, welche vor allem online zu bekommen sind, wird immer größer. Allerdings gibt es nur wenige Informationen zur Internetnutzung von psychiatrischen Patienten im Vergleich zur Gesamtbevölkerung. Sind psychiatrische Patienten bezüglich Zugang zum Internet und Nutzung von Internetinformationen und -therapien benachteiligt?

The thesis is devoted to the issue of involuntary hospitalization in the field of psychiatry. Involuntary psychiatric hospitalization is accompanied by a wide range of ethical issues and practical problems. In the theoretical part of the thesis I describe the involuntary hospitalization from several different points of view. I pay attention to international conventions and documents relating to the issue, reveal the historical roots of involuntary hospitalization, compare the situation in different European countries and mention some important judicial decisions concerning the involuntary admission of a person. Using a comprehensive approach I map all the important aspects of this sensitive area in health care provision. In the research part, using both - the quantitative and the qualitative approach, I offer a more detailed look at two selected aspects surrounding the involuntary hospitalization. The first part of the research is focused on the subjective experiences of involuntarily admitted patients. 88 patients participated in the research. These patients described their perception of coercion, the possibility or impossibility of influencing decisions about hospitalization and subsequent treatment, the level of autonomy and emotional experience. The second part of the research is aimed at...

Magister Scientiae (Nutrition Management) - MSc(NM) / Introduction: The significant link between mental health and nutrition throughout one’s life cannot be overstated. Yet this strong association is often neglected in the public healthcare sector in South Africa, particularly in the case of people who are being treated for various types of mental illness. It is therefore important to prioritise nutrition care through efficient and effective hospital food services in public psychiatric facilities. Although hospital settings are often perceived to provide efficient clinical care, the food provided to patients by hospital food service units is often criticised for being bland, repetitive and/or unhealthy. At times, too, inadequate food budget allocations by provincial health departments or poor supply chain management practices result in patients receiving inadequate quantities of food at mealtimes, which might lead to their becoming malnourished during their hospital stays. For psychiatric patients in particular, malnutrition can have serious short and longer-term consequences.

The thesis is devoted to the issue of involuntary hospitalization in the field of psychiatry. Involuntary psychiatric hospitalization is accompanied by a wide range of ethical issues and practical problems. In the theoretical part of the thesis I describe the involuntary hospitalization from several different points of view. I pay attention to international conventions and documents relating to the issue, reveal the historical roots of involuntary hospitalization, compare the situation in different European countries and mention some important judicial decisions concerning the involuntary admission of a person. Using a comprehensive approach I map all the important aspects of this sensitive area in health care provision. In the research part, using both - the quantitative and the qualitative approach, I offer a more detailed look at two selected aspects surrounding the involuntary hospitalization. The first part of the research is focused on the subjective experiences of involuntarily admitted patients. 88 patients participated in the research. These patients described their perception of coercion, the possibility or impossibility of influencing decisions about hospitalization and subsequent treatment, the level of autonomy and emotional experience. The second part of the research is aimed at...