Dissertationen zum Thema „Mental Health Facility“

The purpose of this study is to assess the attitudes towards individuals with mental illness among the healthcare providers of a long-term care facility. It takes a quantitative, non-experimental, cross-sectional, descriptive approach to view relationships. Minimal research exists in this subject matter, and literature reviews suggest that negative attitudes toward mental illness exist among healthcare providers (Ahmead et al., 2010; Aydin et al., 2003; Bjorkman et al., 2008; Rao et al., 2008; Reed & Fitzgerald, 2005; Ucok, 2008; Ross & Goldner, 2009; Smith et al., 2011; Zolnierek & Clingerman, 2012). The Community Attitudes toward the Mentally Ill (CAMI) questionnaire was given to a sample of 51 long-term care employees. Data was analyzed by using the IBM Statistical Package for the Social Sciences (SPSS) version 20.0, focusing on significant results concerning t-test, chi-square, and correlations in order to answer the research questions. Findings suggest a majority of the employee's attitudes in this long-term care facility were nonauthoritarian, nonsocial restrictive, and nonbenevolent. While there was no significant empirical support for differences in attitudes among RNs, LPNs, and CNAs, certain questions on the CAMI did provide significant results. Related to this there was also no empirical evidence for differences among the attitudes of departments, except when individual analysis of each question was complete. Correlational analysis showed relationships between various variables: education and seeking treatment for oneself, race and previous work experience, department and previous work experience, authoritarian views and gender, authoritarian views and education, nonsocial restrictive view and age, community mental health ideology and age, and community mental health ideology and department. Implications on future research and a discussion of recommendations to further decrease stigma in the long-term care environment are completed.

Psychiatric illnesses can sometimes lead to behavioral outbursts that need to be addressed quickly to deescalate potentially explosive situations. Nurses are in a unique position to respond to such outbursts by calling for a rapid response team. Nurses who are part of the rapid response team should be well-informed of their roles and responsibilities in managing aggressive and violent behavior. The purpose of this project was to explore RN's and LPN's knowledge and perceptions of a rapid response team in a psychiatric facility. The Iowa model of evidence-based practice provided the framework to integrate theory into practice to improve care. A quantitative descriptive design was implemented with a convenience sample of nurses using a 4-part questionnaire. Of the 64 surveys distributed on 5 wards, 59 were completed for a response rate of 92%. Descriptive statistics were used to analyze nurse responses to demographic data and background data. A Chi-square statistic was calculated to investigate the relationship between RN and LPN responses to the Likert Agreement Scale; no significant difference in responses was found. Open-ended questions allowed nurses to comment on their role and position during a code. The comments were sorted into categories of reoccurring themes. Results suggested that nurses need to understand signs of behavioral escalation and strategies to deescalate a potentially volatile patient. Nurses commented that knowledge during a code, reasons for calling a code, and good communication skills are essential in code situations. Findings from this project can benefit nurses who work psychiatric emergencies by underscoring the need to development of psychiatric rapid response teams and to update current standards of inpatient care.

Individuals diagnosed with dementia make up the majority of the population in skilled nursing facilities (SNFs). Certified Nursing Assistants (CNAs) are the primary caretakers of older adults living in SNFs. The purpose of this grant project was to write a proposal for funding to provide Person-Centered Care (PCC) training to help CNAs enhance their skills to better enhance the quality of life of older adults living with dementia in SNFs.

The goal of PCC training is to help CNAs better understand the signs and symptoms of Alzheimer’s and dementia, improve communication skills, and provide strategies to manage the behavioral and psychological symptoms of dementia. Previous research on PCC has found it to be effective in improving the quality of care of older adults who are affected by dementia and who are living in nursing homes.

Actual submission or funding of the grant was not required for the successful completion of this project.

Anxiety and behavior disturbances are a significant problem for geriatric residents living in a facility. Currently treatment for these symptoms is pharmacological. While medications are necessary in some cases, significant uncomfortable side effects can result. The availability of effective treatments that are non-pharmacological allows nurses to offer an alternative option for these symptoms. The purpose of this project was to investigate animal-assisted therapy (AAT) and the effects this therapy has on anxiety and behavioral symptoms for geriatric patients living in a facility. A four week study was conducted with adult subjects age 55-85 who were diagnosed with anxiety or behavior symptoms and live in a facility. A dog was utilized for the therapy. Evidence suggests the effectiveness of AAT for a multitude of disease states and medical conditions. Use of ATT in this study revealed several behavioral changes for individual participants.

Two six-week research studies in two different geriatric facilities were conducted on how art making affects the anxiety levels, depression levels, and symptomology of geriatric patients with a diagnosis of COPD. There were 10 participants total between the two studies, all with varying stages of COPD and different symptoms of depression and anxiety.

The participants attended a one-hour creative arts therapy group once a week for six weeks. During each week, a different art directive was presented with new materials and new themes. Through pre- and post- self assessments each group, research showed how these art materials, discussions, and directives affected their medical and emotional symptoms. Research demonstrated how medical and emotional symptoms are intertwined, often greatly affecting one another. Providing art directives and group support, this study provided ways to observe how affecting one symptoms may possibly benefit other underlying symptoms and even a person's well-being as a whole.

This Art-Based Research (ABR) illuminates the power of creativity to inspire and heal people living in a maximum-security forensic psychiatric hospital. The study comprises: the individual and group artwork from the Collaborative Ceramic Art Therapy Studio with thirteen participants; a culminating thirteen-minute film found at https://www.youtube.com/watch?v=PytlFZVvlig, Conversations in Clay: Creativity, Collaboration, and Community; an artistic inquiry and examination of the project footage; and a discussion of how the therapeutic filmmaking process helped capture the essential therapeutic elements of clay, filmmaking, and the art therapy studio environment.

Severely mentally ill adults are a historically underserved population that tends to be highly resistant to taking psychiatric medications. Although medications generally help to decrease the severity of symptoms and lower risk of relapse/hospital readmission, they also negatively impact sense of self and identity, and lead to unwanted side effects. Non adherence frequently leads to involuntary hospitalizations, where a medication adherence intervention is needed. In order to make a case for a medication adherence intervention, regression analyses were conducted on an inpatient psychiatric sample of 178 adults diagnosed with severe mental illnesses in order to determine predictive relationships between symptom severity upon admission, frequency of hospital readmission, medication adherence/non-adherence, and length of hospital stay (LOS). Results yielded insignificant findings, which is informative and even compelling due to medications being considered the gold standard in inpatient psychiatric care. Results were limited by medication adherence being measured dichotomously, and confounds related to ethnicity, family involvement, and substance abuse. Post-hoc analyses yielded significant relationships between pretest symptom severity and length of stay, as well as significance between medication non-adherence and elevations on the symptoms: Conceptual Disorganization, Grandiosity, Suspiciousness, and Motor Retardation, which indirectly support concerns about severely mentally ill adults not taking medications due to concerns related to autonomy and distrust of providers. Implications and future research and practice are also discussed.

Aggressive and violent behaviour in inpatient mental health facilities is found worldwide and is a frequent and serious clinical and nursing care problem. Despite the importance of international research findings and recommendations, it appears that patients perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Western Cape, in particular. It is against this background that this study endeavoured to investigate the external and situational contributing to patients aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients perspectives.