Dissertations / Theses: 'Acute Mental Health Facility'

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Waters, Christina Lee. "Design Invites Stories: a mental health facility." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2772.

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This thesis documents the design process for an out-patient mental health facility for veterans of war. Here are some questions that drove my design work. How are stories told in design? How are stories generated from users within a designed space? Can users participate in contributing to a space's design? Many structures create psychological stories through graphics, color, and layout to involve users in their procedures. For example, commercial retailers will setup a story line to promote a more personalized connection with their customers which encourages repeat business, while places of worship also use this narrative strategy to evoke a spiritual experience. Many historical museums are also terrific examples of involving people in a story line to explain their contents. Thus, spaces can also tell stories and involve occupants within these set story lines, but this document and the resulting designed space explore the potential for interior design to generate stories from its users.

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Munro, Sara Louise. "Exploring attitudes in acute mental health nursing." Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499829.

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Methods: Study one; cross sectional survey of all acute mental health nurses working at 10 MHS Trusts (n=2130). The survey contained a validated attitude scale (ATAMH) and questions exploring a range of personal, professional and organisational variables. Study two; semi-structured interviews with acute mental health nurses and service users with experience of acute inpatient care. Results: Study One: The mean total attitude score was 172 which is positive, the maximum score available is 255. Multiple regression analysis identified seven predictors of attitudes which accounted for 21.3% of the variance in the total attitude score: pay banding; influence of psychosocial approaches; influence of involving service users; experience of working in the community; education at post graduate/higher degree level; being up to date on policy, research and practice relevant to acute mental health care; having personal and family experience of mental health problems. Study Two: 16 nursing staff from two units covering a range of pay bands and length of experience were interviewed. Ten service users with a range of acute inpatient experience were interviewed. Three overarching themes were identified: 1) Pre-determined factors influencing attitudes such as personality, reasons for doing the job, personal and family experiences of mental health problems 2) Wider contextual factors such as clinical leadership, patient stereotypes, ward culture and team values 3) Outcomes of nursing practice and the service users experience of care. Nurses who had positive attitudes made patients feel valued. Nurses with negative attitudes made patients feel like they were a pain and not deserving of care. Service users believed pre-determined factors had the greatest impact on nurses' attitudes. Nursing staff placed greater emphasis on the influence of contextual factors and underestimated the impact of attitudes on service users' experience.

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Brown, Malgorzata. "Therapeutic relationships in acute inpatient mental health settings." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12508/.

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This work considers the nature of therapeutic relationships between nursing staff and patients on acute mental health inpatient wards. Section A is a literature review, exploring the psychological theories behind the care delivered by nurses through the medium of therapeutic relationships in inpatient settings and providing a meta-synthesis of studies investigating the nature of therapeutic relationships between nursing staff and patients from the perspectives of nurses. Section B presents a phenomenological study in which nursing staff completed in-depth interviews providing descriptions of their therapeutic relationships with patients. The results suggest a great variance in the nursing staff ability to get to know and understand patients and their needs from a psychological perspective. The knowledge gained about patients through the medium of relationships did not seem to be shared by the staff team and did not seem to be integrated into a coherent treatment plan.

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Poopedi, Lehlogonolo Kwena. "The experiences of social workers in the provision of mental health services at Weskoppies mental health facility." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/78413.

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Mental health seems to be a growing area of concern worldwide with the number of people suffering from mental health issues rapidly increasing. In South Africa, over 17 million people are reported to be suffering from mental illness and mental health problems. Those suffering from mental health problems are identified as a vulnerable group greatly depending on the social work intervention and service provision for recovery. As a result, social workers form part of the five core professional groups in the field of mental health worldwide. The provision of mental health services by social workers is subject to numerous realities that have a significant impact on their overall experiences in the field however there has been little to no research conducted on the experiences of social workers in providing mental health services. Therefore, the rationale of the present study was to address the identified knowledge gap in literature by conducting research specifically looking into the experiences of social workers in the provision of mental health services at Weskoppies mental health facility. The goal of the present study was to explore and describe the experiences of social workers in the provision of mental healthcare services specifically at Weskoppies mental health facility. The present study was qualitative and employed the instrumental case study design in order to generate an understanding of the experiences of social workers in providing mental health services through thick and rich descriptions of the cases studied. The ten (10) social workers who participated in the present study were purposively sampled using the following sampling criteria: the social worker had to be providing mental health services at Weskoppies mental health facility; be registered with the South African Council for Social Service Professionals (SACSSP) and be in possession of a recognised bachelor’s degree from a South African university; have six months or more experience in mental health; give consent to participate in the study and be able to speak and understand or converse in English. Semi-structured one-on-one interviews with an interview schedule were utilised to collect data from the participants. The research findings show that the absence of a clear set scope of practice for social workers providing mental health services results in role confusion and also in social workers being subject to tasks falling outside of their broad scope of social work practice (for example, accompanying patients to the ATM or collecting patient parcels at an institutional gate/entrance). The risks with such tasks are observably not covered in danger allowances as the research explains in detail in analysed findings. In addition to the above, a lack of resources was identified as the main challenge affecting the overall quality of social work service provision and interventions. The findings also indicate that there is a great gap in mental health content within the undergraduate social work degree and that the degree alone is inadequate in capacitating social workers to undertake effective practice in mental health. Supervision and workplace training seem to be effective measures in bridging the presenting gaps resulting from the undergraduate BSW degree. Recommendations include capacity building for social workers providing mental health services through the Inclusion of mental health modules in the undergraduate social work degree as well as the development of a clear set scope of practice for social workers providing mental health services. Key Concepts: Social Worker, Mental health, Mental health services, Mental illness, Mental healthcare user, Metal health facility, Weskoppies mental health facility, Experiences
Mini Dissertation (MSW (Health Care))-University of Pretoria, 2020.
Social Work and Criminology
MSW (Health Care)
Unrestricted

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McKeown, Margaret Mary Olive. "Dual diagnosis : a challenge for acute mental health nursing." Thesis, University of Kent, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.420833.

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Walker, Matthew S. "Exploring stigmatizing attitudes toward mental illness in a midwestern long-term care facility." Thesis, Blessing-Rieman College of Nursing, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1561036.

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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.

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Smith, G. M. "Overriding the choices of mental health service users : a study examining the acute mental health nurse's perspective." Thesis, Liverpool John Moores University, 2018. http://researchonline.ljmu.ac.uk/8976/.

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This study explores the mental health nurse’s experience of ethical reasoning while overriding the choices of mental health service users within an acute mental health context. When working with service users in acute mental distress a mental health nurse’s clinical decisions will have a controlling element, which can lead to the service user’s freedoms being restricted. This power to restrict freedoms also known as coercion can be explicit, it follows the rule of law, and implicit; ways of controlling that are ‘hidden’. The ethical use of this power requires the nurse to be an effective ethical reasoner who understands both the explicit and implicit nature of this power. Coercive power, which is explicit, has been thoroughly explored; however, there is limited work exploring the use of this power within an ethical context and as a ‘real-time’ practice issue. In addition, there is little work exploring implicit power as a practice issue or as an ethical issue. To examine this knowledge gap this study adopts an interpretative phenomenological analysis (IPA) approach to engender an understanding of the mental health nurse’s personal meaning and experience of using both explicit and implicit coercive power. This approach affords the researcher the opportunity to tease out the personal ‘ethical’ meaning of the participants’ experiences by facilitating an in-depth and sensitive dialogue, which focuses on stimulating conscious ethical reflection. IPA is an idiographic mode of inquiry where sample purposiveness and analytical depth is more important than sample size. On this basis, six qualified mental health nurses were recruited who have used coercive strategies while nursing service users in acute mental distress. The semi-structured interviews were thematically and interpretively analysed, the five superordinate themes that were generated are; the nurse as a practitioner, their values, their practice, their use of coercion, and their ethics. In addition, the results of the study highlighted that coercive strategies are a key part of a mental health nurse’s daily practice both explicitly and implicitly. These strategies can be beneficent; however, this is dependent on the ethical reasoning ability of the nurse and the professional support they receive in practice. Being an effective ethical reasoner requires the nurse to acquire ‘good habits’, a basis for enabling the nurse to work through an ethical challenge in ‘quick time’. Furthermore, to enhance these good habits they also need to have an ‘ethical imagination’. Considering these points, this study recommends mental health nurses when using coercive power use a multi-faceted ethical reasoning approach. This approach should aim to create good ethical habits through continually rehearsing good responses to common practice issues. In addition, this approach should not neglect the need for the nurse to use their ethical imagination and to feel for an ethical solution where required. As a future area for research, this study recognises the skilled use of ethical imagination in the field of mental health nursing requires further exploration.

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Eldridge, Sarah Marie. "The Barriers To Mental Health Services: How Facility Factors Impact Perceived Barriers To Mental Health Services In Nursing Facilities." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1409246124.

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Lim, Eric. "How mental health nurses can use recovery-focused care to reduce aggression in the acute mental health settings." Thesis, Curtin University, 2022. http://hdl.handle.net/20.500.11937/88694.

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This hybrid thesis presents a two-phase sequential exploratory mixed methods research that explored mental health nurses’ and consumers’ beliefs of how recovery-focused care can be used to reduce aggression in the acute mental health settings. The thesis is comprised of traditional thesis chapters and five peer-reviewed publications. The findings of this research provide evidence-based knowledge for mental health nurses to understand how they can translate the use of recovery-focused care clinically to reduce aggression.

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Brimblecombe, Neil. "An acute community mental health service : assessments, descriptions, predictions and implications." Thesis, Brunel University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.250209.

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Cecil-Riddle, Kimberly. "Nurses' Knowledge and Perceptions of Rapid Response Teams in a Psychiatric Facility." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1148.

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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.

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Cecil-Riddle, Kimberly. "Nurses' Knowledge and Perceptions of Rapid Response Teams in a Psychiatric Facility." Thesis, Walden University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3633624.

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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.

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Donaghay-Spire, Eloise G. "An exploration of psychological interventions in the acute inpatient mental health setting." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12867/.

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Literature suggests that individuals experiencing acute mental health difficulties can benefit from psychological input, with calls to increase psychological provision in inpatient mental health settings in the United Kingdom (UK). Despite this, there is limited research to support this demand, which may in part be due to inherent difficulties in conducting research in this setting. Using an interview design and narrative analysis, this paper explored staff members’ and service-users’ experiences of inpatient psychological interventions in National Health Service (NHS) inpatient mental health settings. Evidence was found to support the use of direct, indirect and strategic interventions for individuals, groups, families and staff teams. Formulation and the therapeutic relationship were conceptualised as common features of such input. Connections between inpatient psychology and change within the stories suggested that interventions can help people make sense of a crisis, improve relationships and contribute to meaningful recovery. Barriers were also presented, suggesting that psychological input in this setting might not be right for everybody. This paper demonstrates that psychological input in the acute inpatient mental health setting is perceived as meaningful and can lead to changes. There is also a sense that this provision can be challenging, highlighting the need for further research.

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Le, Thien Thanh. "Resilience and mental health in parents of children surviving Acute Lymphoblastic Leukaemia." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-14882.

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Our main findings in the present study are that parents of children surviving leukaemia have in general an average level of resilience. Regarding mental health, fathers show more mental health symptoms. Fathers struggle with depression and anxiety, while mothers show no such symptoms. Despite showing symptoms for depression and anxiety, fathers are still capable of being structured and having social competence in the daily life. The same goes for mothers who manage future planning well. As a result, the first hypothesis which stated that parents of ALL children had weaker resilience, as well as the second hypothesis about the relationship between high resilience and good mental health can be rejected. The course of childhood cancer is not predictable for either children or parents. Some children respond rapidly to treatment, and have a relatively smooth course, while others go through a tough time and experience more difficulties. Parents’ physical and mental health also fluctuates during the active cancer period. The child and the parents affect each other by their adaption and coping style. Besides researchers and health care professionals, other parents and family members in the same situation, will also gain from new knowledge about protective factors and other factors that might lead to or strengthening ones’ resiliency and mental.

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Bentley, Mary Charity. "How clinical psychologists experience working in an acute mental health inpatient setting." Thesis, University of Hertfordshire, 2014. http://hdl.handle.net/2299/14328.

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The focus of this study was to explore how Clinical Psychologists narrate their experience of working on acute adult inpatient units. Mental health services in the UK are poorly resourced with treatments dominated by medical model perspectives. This model can conflict with the psychological and social models Clinical Psychologists are trained in. The aims of this study were to explore the experience of Clinical Psychologists working in acute adult inpatient units and, through this, develop insight into how the core values for improving inpatient care could be maintained. This study was guided by Social Constructionist principles. It required a critical stance to be applied on the current system with an understanding that knowledge is co-constructed between and within relationships. Eight individual semi-structured interviews with Clinical Psychologists who work on adult acute inpatient units were conducted and explored using Narrative Analysis. Four dominant narratives were found. These were; ‘You can’t beat the system’, ‘I am screaming’, ‘Connecting with humanity’ and ‘Someone is screaming’. These narratives related to the Clinical Psychologists themselves in conjunction with the system they were working in which included staff, patients, myself as the interviewer and society in general with the understanding that the interviews were co-constructed and represented multiple voices. This research confirmed that cuts and lack of resources to NHS services have created a massive strain on the system. The Clinical Psychologists working in this system are attempting to understand and support individuals in acute distress; however, they appear to be doing this in isolation which puts them in danger of burn out. It would seem the system is organised against thinking and feeling, affecting both staff and patients, and leaving their experiences unheard and invalidated. The people who are admitted to wards are likely to have had abusive and invalidating earlier experiences. Wards need to be a safe place where they can have time to express themselves, process this and experience validation. The opposite seems to be happening, thus, potentially perpetuating their experience of abuse and neglect. Compassion is a Government directive, yet it takes time and space and, thus, is not cost-efficient. To achieve a system, where people who are vulnerable can express their distress and feel heard, provision of ongoing support and resources is required. Further research could explore the experience of staff who work on inpatient units, for instance health care assistants, nurses, psychiatrists and managers in order to provide further insight into the system that is currently in place and help to develop ways to improve it. It would also give voice to professions that did not have a voice in this research. Experiences of Clinical Psychologists on inpatient units where the medical model is not dominant could also be explored, for instance, where the Open Dialogue approach is dominant. Comparisons between the different approaches could then be explored.

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Billmeyer, Tina W. "Evaluation of a behavioral health integration program in a rural primary care facility." Huntington, WV : [Marshall University Libraries], 2007. http://www.marshall.edu/etd/descript.asp?ref=755.

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Chow, Sau-king Debbie. "Rejection sensitivity and psychological health of Hong Kong elderly: does discriminative facility help?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B29740307.

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Merga, Desalegn Bekele. "Barriers to physical health care in persons with severe mental illness: a facility based mixed method study in Ethiopia." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/13803.

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People with severe mental illnesses (SMI) face barriers that contribute to poor physical health outcomes. However, these barriers have not been systematically investigated in Ethiopia. Aim: The aim of this study was to examine barriers to care for physical co-morbidities among SMI patients. It achieves this by: i) estimating the prevalence of physical co-morbidities in SMI in-patients in a psychiatric referral hospital over a two month period; ii) describing potential associations of various socio-demographic and clinical factors with the occurrence of physical co- morbidities in admitted patients with SMI; and iii) exploring barriers in recognition and management of these physical comorbidities in the immediate curative medical care environment of admitted SMI patients in the psychiatric referral hospital. Methods: The study used a mixed methods design that included: i) a quantitative cross-sectional facilitybased record review; and ii) a qualitative exploration of potential or experienced barriers to physical health care provision by patients, caregivers, mental and general health professionals. The quantitative component estimated prevalence and examined risk factors associated with the presence of co-morbid physical health conditions among people with SMI. For this, clinical records of all admitted patients with diagnosis of SMI were reviewed over a two-months period. To check the reliability of the clinical records, a pilot test was done for two weeks before actual data collection. By using systematic random sampling of the records reviewed, 30 patients were selected for physician assessment in order to check the accuracy of the information included in records. The qualitative section was conducted using semistructured interviews with SMI patients and their caregivers and focus group discussions with service providers.

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Bonner, Gwen. "The psychological impact of restraint in acute mental health settings : the experiences of staff and inpatients." Thesis, University of West London, 2007. https://repository.uwl.ac.uk/id/eprint/417/.

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Restraint has been used as a method of managing untoward incidents in mental health practice since mental health care began. Although methods of managing untoward incidents have evolved over time, restraint remains to this day the principal model for managing violent and aggressive behaviour in acute mental health settings. Despite restraint being a dominant force in acute mental health care, the psychological impact of this intervention upon staff and patients is relatively unknown with very little research devoted to this area. Guidelines suggest that some form of Post Incident Review should take place following untoward incidents but this is patchy in many areas, and the efficacy of approaches to Post Incident Review has not been clearly documented in related literature. Furthermore, some staff and patients have reported that the experience of restraint triggers memories of previous traumatic encounters which have caused further distress to them during, and in the aftermath of, restraint. This study explores the psychological impact of restraint for staff and patients who are involved in these procedures. In addition, a framework for Post Incident Review is evaluated to establish whether this is a helpful tool to address some of the limitations of current approaches to Post Incident Review. The phenomena of restraint reawakening memories of previous traumatic encounters is also considered within the study to establish whether this has a bearing upon the experience of restraint for those involved in the procedure. The results highlight that the experience of restraint is distressing for staff and patients. The psychological impact ranges from minimal effects, to distress, through to full-blown Post Traumatic Stress Disorder (PTSD). The framework for reviewing incidents was well received by staff and patients and is offered as a way forward in providing a more structured approach to considering untoward incidents between staff and patients. This study has found that the experience of restraint does reawaken memories of previous traumatic encounters for both staff and patients. The study concludes with recommendations for education, further research and clinical practice.

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Deacon, Maureen. "'I can't get a thing done' : an ethnography of acute mental health nursing." Thesis, Manchester Metropolitan University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399661.

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Chabinska, Joanna. "Burnout, depression and job satisfaction in acute psychiatric and secure mental health settings." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/23570.

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Chapter 1: Objective: The systematic review aimed to review the literature on burnout and its relationship to depression within the acute in-patient mental health services: psychiatric units and specifically, secure forensic mental health services. Methods: The review process included a systematic search across five databases (Medline, PsychINFO, Cinahl Plus, EMBASE and SCOPUS). Eligible studies included a cross-sectional design, using validated measures on burnout and depression. Results: A strong relationship between depression and emotional exhaustion was found. The relationship between depression and two other burnout dimensions (personal accomplishment, depersonalisation) was weaker and better explained in the context of other predicting (anxiety) and mediating (transformational leadership) variables. While depression severity across the studies was mostly mild with average burnout, service-specific variations were observed. Chapter 2: Objective: The empirical study aimed to explore any direct relationships of subjectively perceived understanding, predictability, control (job demands) with burnout and job satisfaction, and direct/in-direct effects of social support, psychological mindedness and psychological inflexibility (external and internal resources) on these relationships. Methods: Data was collected among Scottish National Health Service (NHS) employees (n=198) working in secure mental health services; forensic (58.65%) or intellectual disability (41.35%). Data gathered from the final sample of 141 nursing staff was analysed using t-tests, bi-variate correlations, hierarchical regressions and a series of mediation, moderation and moderated-mediation analyses. Results: The empirical study revealed that individual burnout dimensions were predicted by different job demands. Social support appeared as predictor rather than a moderator of job satisfaction and emotional exhaustion while psychological inflexibility was a mediator for job demands and burnout. Overall Conclusions: Concluding remarks for both, systematic review and empirical study, identify the need for further research, especially within the forensic mental health speciality. Both highlight that direct and in-direct effects may be important in explaining burnout while the empirical study makes further suggestion with regards to likely individualised pathways and two important resources of social support and psychological flexibility.

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D'Oliveira, Jenna. "Occupation-centred practice : perspectives of occupational therapists working in acute mental health care." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/78424.

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Introduction: The prevalence of mental disorders is rising across the world and in South Africa driving the need for effective, occupation-centred practice in acute mental health care. In the acute setting, however, many occupational therapists experience challenges to practising in an occupation-centred manner. Occupation though remains the core construct of occupational therapy and occupational therapists everywhere are being urged to rediscover the power of occupation and embrace, develop, and maintain an occupation-centred practice. Aim: This study aimed to describe occupation-centred practice from the perspective of occupational therapists working in acute mental health care, in and around the City of Tshwane, South Africa. Methodology: A qualitative, explorative, descriptive design was used. Through maximum variance purposeful sampling nineteen participants were recruited to two focus groups. Transcriptions were analysed using the six steps of thematic analysis as described by Braun and Clarke to construct themes. Results: Four themes were constructed namely, 1. The process of occupation-centred practice, 2. Activities enable occupation-centred practice, 3. The theoretical underpinnings of occupation-centred practice and 4. Influencers of occupation-centred practice. Conclusion: Occupational therapists confirmed the centrality of occupation in their practice and further described occupation-centred practice as a process that entails the use of activities to facilitate experiences. Theoretical constructs that were helpful in guiding occupation-centred practice were highlighted. Influencers were experienced as either supporting or constraining occupation-centred practice. Significance: This study contributes to the evidence base of the profession in South Africa, ensuring that Occupational Therapy maintains its unique role and contribution to acute mental health care.
Dissertation (MOccTher)--University of Pretoria, 2020.
Occupational Therapy
MOccTher
Unrestricted

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Le, Thao. "Person-centered training to promote quality of care to skilled nursing facility residents affected by dementia| A grant proposal." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024098.

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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.

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Hudson, Nancy J. "Animal assisted therapy and the effects on anxiety and behavioral symptoms for geriatric patients living in a facility." Thesis, Northern Kentucky University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10239719.

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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.

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Gokim, Maria L. "Treatment at a transitional residential facility: Effects on positive and negative symptomology." Scholarly Commons, 1997. https://scholarlycommons.pacific.edu/uop_etds/2674.

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Traditional treatment for schizophrenia addresses behaviors that are present in excess (positive symptoms) but neglects behaviors that are absent (negative symptoms). This leaves individuals unprepared for living in a "least restrictive setting" and results in recurring placements in community settings, an increase in symptoms, and consequent return to treatment and stabilization in an inpatient psychiatric facility. Within an institutional cycle design with nine cohort groups of individuals, this study used archival data from a facility that prepares individuals for community placement to investigate the efficacy of a treatment approach designed to reduce both positive and negative symptomology and decrease use of inpatient psychiatric facilities. The results indicate small effects on positive and negative symptomology but substantial reductions in the use of inpatient psychiatric facilities.

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Field, Thomas A. "Implementing Dialectical Behavior Therapy for Adolescents in an Acute Inpatient Psychiatric Setting." Thesis, James Madison University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3620455.

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Although evidence-based practices (EBPs) have been identified in the literature, insufficient information exists about how to successfully implement them. As a result, implementation efforts have been met with failures. Little is currently known about what affects the success of implementation efforts for best practices such as Dialectical Behavior Therapy for adolescents (DBT-A) in an acute inpatient psychiatric setting (AIPS). A longitudinal multiphase mixed methods case study examined an implementation effort to provide DBT-A in an AIPS over a 24-month period. The process of implementation was investigated through in-depth interviews, a focus group, and field observations. Six categories were identified that affected the DBT-A implementation in an AIPS: appeal of DBT as a treatment modality, impact on patients, implementer characteristics, the implementation process, organizational dynamics and structure, and staff support. Implications for implementing EBPs within organizational environments are discussed. This study represents the first attempt to use qualitative and mixed methodology to examine the process of DBT implementation in an AIPS.

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Jacobs, Yuche Andy. "The experiences of facility-based counsellors who provide a psychosocial intervention for mental illness in primary healthcare facilities in the Western Cape." Master's thesis, University of Cape Town, 2020. http://hdl.handle.net/11427/32498.

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Background: Despite the movement in global mental health that advocates for task-sharing, few studies have investigated the experiences of facility-based counsellors (FBCs) who provide a psychosocial intervention for mental illness in primary healthcare. Project MIND, a cluster-randomized controlled trial at 24 primary healthcare facilities in the Western Cape, trained FBCs to deliver a threesession evidence-based intervention for patients with a common mental disorder. Therefore, project MIND presents an opportunity to address a gap in the literature by exploring the experiences and needs of FBCs delivering a psychosocial intervention. Aims & Objectives: The overall aim of this study is to explore the experiences of FBCs working on Project MIND in the dedicated (training and adding a counsellor to the chronic disease team) and designated (training and using existing counsellor from the chronic disease team) intervention arms. Specific objectives included: (1) exploring the barriers and challenges that FBCs experienced while delivering a psychosocial intervention; (2) exploring FBCs' perceptions of regular structured supervision, debriefing and in-service training for improving micro-counselling skills; and (3) eliciting suggestions from the FBCs for future scale up of counselling services in primary healthcare settings. Methods: A qualitative study was conducted among FBCs delivering the project MIND psychosocial intervention (N=18). All interviews were conducted by an independent qualitative interviewer in a private room at the primary healthcare facilities. Interviews were audio-recorded and transcribed verbatim. NVivo 12 was used to store data and facilitate analysis using the Framework Approach. Results: Findings of the study were grouped according to four main themes. The first theme focused on FBCs' perceptions of the benefits of the project MIND training. Several perceived benefits were reported such as having a better understanding about mental illness particularly depression, enhanced counselling skills and transferability of skills to other daily duties in the healthcare facility. Role-playing stood out as a key training component to assess counselling readiness. The second theme focused on barriers and facilitators related to the implementation of the project MIND intervention. Designated FBCs reported competing task demands as a barrier to implementing the MIND intervention compared to designated FBCs. Further, most designated counsellors reported feeling marginalized in the facility due to their lowly status. Other barriers reported which impacted on their motivation to implement the MIND intervention by both dedicated and designated FBCs were low remuneration, a lack of counselling space, and a lack of privacy and confidentiality. Regarding facilitators to implementing the MIND intervention, experiencing first-hand how well patients were able to solve some of their problems using the problem-solving method and taking responsibility for their health motivated FBCs to implement the MIND intervention. In addition, the MIND intervention aided FCBs with solving their own problems which enhanced their belief in the effectiveness of the intervention. The third theme dealt with how FBCs perceive the clinical supervision and debriefing provided by project MIND. Regular structured supervision, debriefing and in-service training delivered by a registered psychological counsellor, a novel approach, was perceived as beneficial to all FBCs as it provided them with a means to reassess and improve their counselling skills. Further, role-playing was reported as an effective method for rehearsing their counselling skills and enhancing quality of intervention delivery. Fidelity feedback through audio-recorded counselling sessions was highlighted as feasible. Considerations around space, location (distance), a lack of privacy, and scheduling were mentioned. The fourth and final theme focused on FBCs' recommendations for improving the project MIND training, supervision and debriefing model, and implementation. FBCs recommended that more time should be allocated for role-playing and skills rehearsal exercises during training to test their counselling skills and readiness. There were some suggestions that the amount of training hours per day should be reduced as it might aid FBCs to remain focused and retain information. Regarding supervision, a few FBCs recommended incorporating occasional peer group supervision and debriefing to benefit from shared experienced. Other recommendations were adding content related to substance use to the intervention and including management in training. Conclusion: Regular structured supervision, debriefing and in-service training provided by a Registered Counsellor are both feasible and beneficial for improving micro-counselling skills and the quality of intervention delivery among FBCs delivering a psychosocial intervention. Considerations for scaling up FBC-led psychosocial interventions should involve addressing barriers such as limited counselling space, remuneration, and marginalization.

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Laker, Caroline Jane. "Overcoming barriers to change in acute mental health wards : the effects of staff perceptions." Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/overcoming-barriers-to-change-in-acute-mental-health-wards-the-effects-of-staff-perceptions(eb78f5f8-109e-483b-80d9-1704877fc642).html.

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Background: Capturing how nursing staff perceive barriers to change may clarify why, despite investments to improve mental health wards, change has been problematic. Given changes are disruptive and wards are frequently volatile, detrimental effects such as worsened perceptions, reduced work satisfaction and burnout are likely. However, there are currently no measures of perceptions of barriers to change for use in mental health wards. Aims: i. Undertake a qualitative investigation into how nursing staff conceptualise barriers to change; ii. Develop a measure of perceptions of barriers to change; iii. Psychometrically test the measure; iv. To explore baseline factors which affect perceptions of barriers to change; v. To explore the relationships between staff perceptions of barriers to change, ward climate, work satisfaction and burnout; vi. To explore whether participation in an intervention worsens perceptions of barriers to change and to consider the influence of ward climate; vii. To explore whether perceptions of barriers to change worsen work satisfaction and burnout across time, in the context of participation in an intervention. Methods: Perceptions of barriers to change were examined using mixed methods and by adopting a model of stakeholder involvement. Interviews were undertaken, and then thematically analysed, to produce VOCALISE: a measure of perceptions of barriers to change. Following psychometric testing, VOCALISE was used in a randomised controlled trial introducing intensive changes. This allowed cross-sectional and longitudinal relationships (between VOCALISE, ward climate, work satisfaction and burnout) to be examined, using multi-level regression modelling. Results: VOCALISE had promising psychometric properties. Three subscales were identified capturing themes of resistance including powerlessness, low confidence and demotivation. At baseline, VOCALISE was predicted by ward climate, incidents and temporary staff. Staff with more negative perceptions of barriers to change had increased burnout and reduced work satisfaction. At baseline and follow up, younger and direct care staff had worse VOCALISE scores than older and more senior staff. At follow up, the impact of change and baseline ward climate led to poorer perceptions of barriers to change in the intervention group than in the control group. Negative baseline VOCALISE scores predicted work dissatisfaction, and this effect was greater in the intervention group. Discussion: As change had a detrimental impact on perceptions (particularly for direct care and younger staff), future research should consider how to reduce the burden of innovation in challenging work environments, like acute wards. This may improve how staff respond to changes, and increase work satisfaction and the quality of care offered to service users.

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Paterson, Charlotte. "Psychological intervention for acute mental health inpatient care : a meta-analysis and feasibility study." Thesis, Edinburgh Napier University, 2018. http://researchrepository.napier.ac.uk/Output/1256371.

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Psychological intervention has been recommended to address some of the common problems reported in acute psychiatric inpatient services, such as having nontherapeutic environments, minimal provision of therapeutic interactions and activities and highreadmission rates. There is a small evidence base investigating the effectiveness of acute inpatient psychological therapy, however, this has never been reviewed or synthesised. Robust investigation of cross-diagnostic inpatient psychological intervention is alsoabsent, and whether this is feasible is unknown. Informed by the Medical Research Council (MRC) framework, this thesis examined and synthesised the current evidence base of controlled trials of psychological therapy for acute psychiatric inpatients for the first time. It also tested the feasibility of implementing and evaluating cross-diagnostic psychologically informed acute mental health care in comparison to treatment as usual. The latter was largely based on the Woodhaven Approach, which is theory-driven psychological model of care. The model offers psychological intervention for acute inpatients and targets mechanisms of psychological dysfunction identified by the Interacting Cognitive Subsystems model (ICS). This thesis, therefore, comprises two main studies: 1) a meta-analysis, and 2) a feasibility study. The meta-analysis focused on the effectiveness of brief inpatient psychological therapyon psychotic symptoms, risk of readmissions, and emotional distress (depression and anxiety). Results showed that in randomised and single-blind studies psychological intervention had little effect on psychotic symptoms. Other outcomes, however, showed more promising results. For example, although not significant, robust evidence suggests that brief psychological therapy may reduce emotional distress and risk of readmission for some acute inpatients. The feasibility study aimed to test the feasibility of implementing and evaluating a cross diagnostic psychological model of acute inpatient care, and gather preliminary clinical outcome data. Using a framework of methodological issues, the feasibility study showed that some aspects of the trial processes were run successfully, i.e. some clinical outcomes had good completion rates, some intervention components were successfully implemented and some outcomes produced effects which favoured the intervention group over the control group. However, other aspects of the trial processes were problematic and required amendment before progressing to a full trial. Key issues identified by the feasibility study include problematic eligibility criteria, poor implementation of some intervention components, poor engagement, poor completion of follow-up questionnaires and therefore poor trial retention. The feasibility study also highlighted methodological issues which have not yet been addressed, but are important in planning a future definitive trial, i.e. randomisation and assessor blinding. This thesis has provided the first study to test the feasibility of evaluating the effectiveness of this psychological model, in comparison to treatment as usual, and it was the first time the impact of this psychological model has been investigated in relation to re admissions. Overall, this thesis indicates that a cross-diagnostic approach to acute psychiatric inpatient psychological therapy is feasible, however further work is needed to fully implement the model into routine practice.

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Oakley, David. "Exploring loneliness and connectedness amongst service users in acute adult mental health inpatient care." Thesis, Bangor University, 2017. https://research.bangor.ac.uk/portal/en/theses/exploring-loneliness-and-connectedness-amongst-service-users-in-acute-adult-mental-health-inpatient-care(93f2727c-430c-4ac1-9b0f-4708e1f3e9ff).html.

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This thesis concerns exploring and understanding loneliness and connectedness amongst service users in acute adult mental health inpatient care, through a qualitative study using grounded theory. The empirical study used a constructivist grounded theory approach to explore the subjective experiences of loneliness and connectedness for service users both immediately before and during an admission to an acute adult mental health inpatient unit. Six service users with a diverse array of psychiatric symptoms were interviewed. Their constructions of how they experienced loneliness and social connectedness were coded with a focus upon identifying actions and processes. Three major categories emerged: (1) factors changing connectedness,(2) responses to changing connectedness and emerging processes, and (3) responding to inpatient care. The small sample size limits the generalisability of these findings. These categories may help identify valuable social processes to consider in acute care, and support further investigations in this area. A narrative literature review evaluated the state of research regarding the subjective experience of loneliness and an area relevant to acute care, the onset of psychosis. The review identified that research has begun to explore whether loneliness may directly or indirectly influence the onset of psychosis, but is currently limited both by the cross-sectional nature of studies, and a lack of understanding of how the construct of loneliness might be different for people with psychosis. A need for further research across more diverse populations is highlighted in a third paper, along with other research and clinical implications.

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Woolsey, Ashley D. "How Art Making Affects the Anxiety and Depression Levels and Symptomology of COPD Patients in a Geriatric Facility." Thesis, Hofstra University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1543546.

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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.

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Thibeault, Catherine Ann. "The relationships of hospitalized persons with acute mental illness and their nurses: an interpretive inquiry." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=96692.

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The nurse-patient relationship is prominently featured in nursing discourse, particularly in the literature and practices of psychiatric-mental health (PMH) nurses. PMH nurses have found it challenging to focus on their relational work in the face of pressure to provide efficient, technological, and biomedical care, especially in hospital settings. The purpose of this inquiry was to explore the relational experiences of patients with acute mental illness and their nurses in inpatient psychiatric settings. The researcher engaged in conversations with ten PMH nurses and six patients hospitalized with acute episodes of severe mental illness. Interpretation of transcribed accounts yielded four dominant themes: engagement, withdrawal, mindful approach, and keeping safe. The author discusses the relational practices of nurses and their patients as experienced in the day-to-day world of an acute psychiatric inpatient unit. The author explores relational experiences in brief encounters, as patients and nurses move toward the other in order to understand the other; in psychological work, as they attempt to achieve a shared understanding about future directions; and in practices related to caring for patients with physical needs related to activities of daily living. The author discusses the state of unknowing that some patients and nurses experience as they withdraw from the other. The author concludes that relational practices are a prominent feature of the work of psychiatric-mental health nurses in acute inpatient psychiatric units, but that the nature of these practices may be changing. The author also suggests that despite their occasional experiences of nurses' withdrawal and absence, patients highly value the experience of working with nurses in supportive, health-promoting relationships.
La relation personnel infirmier-patient a été un élément important du discours en sciences infirmières, particulièrement dans la documentation et la pratique du personnel infirmier en psychiatrie-santé mentale. Les infirmières/infirmiers en psychiatrie-santé mentale rencontrent des difficultés à se concentrer sur leur travail relationnel face à la nécessité de fournir des soins efficaces, technologiques et biomédicaux, particulièrement en milieu hospitalier. L'objectif de cette enquête était d'explorer les expériences relationnelles des patients atteints de maladies mentales aiguës et de leurs infirmières/infirmiers en milieu hospitalier psychiatrique. La chercheuse a engagé des conversations avec dix infirmières/infirmiers psychiatriques et six patientes/patients hospitalisés dans des unités de soins psychiatriques intensifs. L'interprétation de la transcription des conversations a révélé quatre thèmes dominants : engagement, repli sur soi, approche attentive et sentiment de sécurité. L'auteure discute des pratiques relationnelles du personnel infirmier et de leurs patients telles quelles sont vécues dans l'univers quotidien d'une unité de soins psychiatriques intensifs. L'auteure explore ces expériences relationnelles lors de rencontres brèves, lorsque les patients et le personnel infirmier vont l'un vers l'autre afin de mieux se comprendre; lors du travail psychologique, lorsqu'ils tentent de parvenir à une compréhension commune de l'orientation future; et lors des pratiques liées aux soins des patients présentant des besoins physiques en liaison avec les activités de la vie quotidienne. L'auteur discute du sentiment d'ignorance éprouvé par les patients et le personnel infirmier lorsqu'ils s'éloignent l'un de l'autre. L'auteur conclut que les pratiques relationnelles sont un élément important du travail des infirmières/infirmiers d'unités de soins psychiatriques qui ont participé à cette enquête, mais que la nature de ces pratiques pourrait être en train de changer. L'auteur suggère également qu'en dépit des expériences occasionnelles de retrait et d'absence du personnel infirmier, les patients interrogés dans cette enquête accordent une grande importance à la collaboration avec le personnel infirmier dans le cadre de relations de soutien et de promotion de la santé.

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DeVolder, Toni. "The Acute Effect of Aerobic Exercise on Anxiety Levels." TopSCHOLAR®, 1993. https://digitalcommons.wku.edu/theses/2258.

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The present study sought to determine whether or not state anxiety levels were significantly reduced when individuals participated in aerobic dance workouts of 15 minutes and 30 minutes. Undergraduate university students and faculty enrolled in an aerobic dance class were volunteers in this study. As hypothesized, subjects in the aerobic dance classes did reduce anxiety acutely following both their 15 minute and 30 minute workout as assessed by the STAI (Y-Form State Anxiety). Thus, results indicate that state anxiety may be reduced through aerobic dance with similar situations and individuals. In addition, the study also looked at the posttest state anxiety score differences between the 15 minutes and 30 minutes. The results were not significant, indicating neither length of aerobic dance workout session was superior to the other. These results contribute to a currently expanding area of research examining the relationship between anxiety reduction and aerobic dance.

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Stokoe, Nicole Yvette. "Enhancing the appraisal of acute mental health crisis : the Crisis Risk and Adaptive Functioning Tool (CRAFT)." Thesis, University of Hertfordshire, 2013. http://hdl.handle.net/2299/10310.

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There is a distinct lack of research into the concept of acute mental health crisis. Without investigating the concept of crisis itself, it is not possible to appreciate the attributes of crisis so that it can be measured. This has hampered the development of good psychometric tools for crisis. The aim of this research was to develop the first standardised, valid and reliable measure for the assessment of people presenting to Crisis Resolution and Home Treatment (CRHT) teams. This research utilised qualitative and quantitative research techniques to develop a crisis measure starting with a comprehensive investigation into the concept of acute mental health crisis to identify an item pool and clinically credible item rating scale. A prototype crisis measure was developed and piloted in two NHS CRHTs and data collected. This data was analysed to identify the key areas of crisis assessment (the subscales), a flexible rating scale and scoring system creating a measure named the Crisis Risk and Adaptive Functioning Tool (CRAFT). The CRAFT provides patient crisis profiles highlighting areas of strength, resilience, weakness and vulnerability. A thorough investigation of crisis was completed with CRHT staff and patients through interviews and focus groups. An initial 143 item pool and clinically credible item rating scale were identified and developed into a prototype pilot crisis measure. This measure utilised a flexible rating approach encapsulating both risk and protective factors believed to reflect clinical practice. The measure was piloted and the data analysed to assess the structure of the crisis measure’s item pool using the statistical techniques of Principal Component Analysis (PCA) and Rasch analysis. These analyses resulted in a 66 item measure with 8 unidimensional subscales including; 1) Crisis Recovery Indicators, 2) Adaptive Decision Making, 3) Risk of Harm to Self, 4) Mediating Factors, 5) Daily Structure, 6) Risk of Harm to Others, 7) Feelings and Affect, and 8) Basic Needs. The total variance explained by these 8 subscales was 67.6% with excellent internal reliability as indicated by a Cronbach’s alpha coefficient of 0.98 (p<0.001) and temporal reliability indicated by Spearman’s correlation of 0.971 (p<0.001, one tailed). This suggests that this measure has a strong internal structure and provides stable outcomes over time at both the subscale and global overall measurement levels. Receiver Operator Characteristic curve analysis supported the identification of cut-offs to indicate low, moderate and high levels of crisis and were shown to have good levels of sensitivity and specificity for the crude discrimination between individuals who require CRHT treatment and individuals who do not require CRHT treatment (sensitivity 0.89 and specificity 0.73) and for accurately discriminating between the basic treatment levels of low, moderate and high (sensitivity 0.80; specificity 0.69). One of the great advantages of utilising the Rasch model is that it supports the identification of key characteristics from an item pool. Application of the subscales and the overall measure to the Rasch model identified items that were most representative of underlying constructs and risk, highlighting items of essential essence for assessing crisis in the context of community treatment. These items may act as useful clinical and risk indicators for community assessment. After considering the evidence from the PCA and Rasch analysis for the underpinning construct, the measure was named the Crisis Risk and Adaptive Functioning Tool (CRAFT) to encapsulate both the risk and adaptive functioning (coping and management) aspects measured by the tool. There are a number of clinical implications resulting from the development of CRAFT for the assessment of crisis. This research clearly identifies 8 key areas for crisis assessment and the specific items that describe them. This promises to be a powerful clinical tool as it clarifies the main areas of concern and importance for crisis assessment and provides mental health professionals with a means of assessing and monitoring patients experiencing crisis. In addition to the clinical benefits offered by the CRAFT, it provides an approach to assessing and monitoring crisis to support further research in the area of acute mental health crisis. This research offers significant steps towards the development of a quality measure for crisis assessment. However, it is acknowledged that the process of measurement development is never complete. It simply evolves over time with the aim of coming closer to the valued direction.

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Kottsieper, Petra Heilbrun Kirk. "Predicting initial aftercare appointment adherence and rehospitalization for individuals with serious mental illness discharged from an acute inpatient stay /." Philadelphia, Pa. : Drexel University, 2006. http://dspace.library.drexel.edu/handle/1860/744.

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Reinfjell, Trude. "Children with acute lymphoblastic leukaemia : A study of health-related quality of life, mental health and intellectual aspects." Doctoral thesis, Norwegian University of Science and Technology, Department of Psychology, 2007. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-1782.

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Paper I reprinted with kind permission of Blackwell publishing ©. Copyright Acta Paediatrica, Stiftelsen för Acta Paediatrica and Blackwell Publishing. Paper II is a preprint submitted to European journal of Cancer Care. Paper IV is a preprint version of an article submitted for publication in Nordic Journal of Psychiatry. © 2007, copyright Taylor and Francis. The journal is available online at http://www.informaworld.com, http://www.informaworld.com/smpp/title~content=t713691698~db=all .Paper V is reprinted with kind permission of Den norske psykologforening, Tidskrift for den norske psykologforening ©

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Duckrow, Fonda Serena. "Filmmaking as artistic inquiry| An examination of ceramic art therapy in a maximum-security forensic psychiatric facility." Thesis, Lesley University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10263229.

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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.

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Williams, Ronnetta. "EXPLORING BIOPSYCHOSOCIAL (BPS) FACETS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IN PATIENTS IN AN ACUTE INPATIENT PHYSICAL REHABILITATION FACILITY (IRF)." UKnowledge, 2013. http://uknowledge.uky.edu/edp_etds/12.

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From a BPS perspective, COPD and other chronic diseases may have a significant negative impact on those living with them and may be associated with higher rates of depression and anxiety and lower levels of health-related quality of life (HRQOL). Certain factors, such as spirituality, may influence the negative impact of chronic disease on the relationship between mood and functional independence and HRQOL. Also, gender may influence the relationship between mood, spirituality, and HRQOL for men and women living with chronic diseases. The current study included 136 patients undergoing physical rehabilitation at an IRF. Anxiety, depression, spirituality, HRQOL, and functional independence were evaluated for all. Mediation models were tested to determine the impact of spirituality on the relationships between mood and HRQOL and functional independence, and moderation models were tested to evaluate the impact of gender on the relationships between mood, spirituality, functional independence, and HRQOL. The current study yielded some inconclusive results but did evidence that COPD patients in acute inpatient physical rehabilitation facilities (IRF) have higher levels of anxiety than patients without COPD and also revealed that men with COPD have better HRQOL than do women with COPD. Spirituality was found to partially mediate the relationship between depression and HRQOL in IRF patients with COPD, but gender did not appear to moderate the relationships between mood, spirituality, functional independence, or HRQOL in IRF patients. As few studies on IRF patients with chronic diseases exist, continuing to evaluate patients in IRFs is important to enhance our BPS understanding of chronic disease.

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Messina, Emily Suzanne. "Examining the Effects of Structured and Non-Structured Therapeutic Activity Programming in a Forensic Mental Health Treatment Facility." Diss., Temple University Libraries, 2011. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/149937.

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Public Health
Ph.D.
Examining the Effects of Structured and Non-Structured Therapeutic Activity Programming in a Forensic Mental Health Treatment Facility: North Florida Evaluation and Treatment Center (NFETC) is an evaluation and treatment center for individuals with mental illnesses who are involved in the criminal justice system. NFETC offers services to adult males who are either incompetent to proceed to trial or have been judged to be not guilty by reason of insanity. In 2005, DCF implemented a system of structured programming in their state forensic psychiatric hospitals. Resident programming went from a referral based activity program (approximately 6 hours per week for each resident) to a structured activity program (approximately 24 hours per week for each resident). In the previous system, a resident's involvement in the referral based activity program was initiated by the residents' counselor and based on the resident's interests. In the current structured TAP program, all residents now average 24 hours per week of activity involvement. Resident attendance is mandatory for those well enough to attend programming. Despite the importance decreasing length of stay (LOS) has on state legal and criminal systems, little research exists on the role recently implemented structured programming plays in resident LOS. This study contains Retrospective Quantitative analyses on the relationships between facility programming and resident demographics, criminal charges, mental health diagnoses, LOS, and attendance and participation rates; as well as Qualitative analyses on program offerings and staff impressions of the current structured programming at NFETC. The results suggest that, despite many differences between the samples of residents receiving the two programs, there is a therapeutic value to the activity programs offered regardless of the program setting. With consideration of staff perspectives and quantitative findings, the current program can be restructured to provide additional benefit. The benefits of activity programming in general were evident in the results of the analyses run separately for each program. Within the Referral based programming, residents with lower participation levels had an increased LOS. Within the structured TAP programming, residents with lower participation levels had an increased LOS and residents with high participation levels had a decreased LOS. These results indicate that involvement in therapeutic activities, regardless of programming format, may be beneficial in decreasing LOS. The Qualitative staff interview component of the current research provided additional insight into issues related to the prior and current program offerings at NFETC, much of which were supported by the Quantitative data. Qualitative findings included staff impressions of both programs as well as issues regarding LOS, value of therapeutic activities, accessibility, attendance, resident choice, internal motivation, safety, program content, and resident participation. The issues, if addressed, have the potential to streamline the program at NFETC into a more effective and useful therapeutic element. These Quantitative and Qualitative findings should serve as suggestions for a program revamping at NFETC.
Temple University--Theses

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Ellenbogen, Mark Alexander. "Mood response to acute trytophan depletion in women at genetic risk for major affective disorder and controls." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23270.

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Acute tryptophan (trp) depletion, which purportedly decreases brain serotonin, lowers mood in normal males with a multigenerational family history of major affective disorder (FH+), but not in male controls. In the present study, the hypothesis that a mood lowering response to acute trp depletion may reflect a susceptibility to depression was investigated further. As both a family history of major affective disorder (MAD) and female sex are considered to be risk factors for depression, the effects of trp depletion on mood were investigated in control and FH+ women. The temporal stability of mood change to trp depletion, when rechallenged at least one month later, was also assessed in order to appraise its utility as a putative susceptibility marker. Subjects ingested a trp deficient amino acid mixture on two separate occasions and a balanced control mixture containing trp on another occasion. Compared to the balanced condition, control women exhibited a significant lowering of mood following the trp depletion, whereas in a previous study control men did not. The sex difference in the mood response to trp depletion among controls is consistent with the fact that women are at greater risk for depression than men. Unlike controls, FH+ women showed no lowering of mood, which suggests that serotonin may not be as important in the etiology of depression in these women. The mood response to trp depletion exhibited poor temporal stability, which does not support its use as a susceptibility marker of depression in normal subjects. Its utility as a putative phenotypic marker for MAD awaits further study in FH+ subjects who respond to trp depletion. (Abstract shortened by UMI.)

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Collins, Antony. "Exploring psychological processes in reflective practice groups in acute inpatient wards." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10342/.

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Section A consists of a critical review examining the research evidence relating to the effectiveness of reflective practice groups for staff in psychiatric inpatient settings, and the role of psychologically trained practitioners in providing facilitation using psychological formulations. Section B. The role of applied psychologists working in inpatient services is developing with a greater emphasis on providing support and consultation to staff teams. The research suggests that psychologically trained practitioners who facilitate reflective practice groups using psychological formulations can assist staff in developing a deeper understanding of patients’ difficulties, with the potential for improved treatment outcomes. This study aimed to address some of the gaps in the research by exploring the experiences of acute psychiatric inpatient ward staff attending reflective practice groups facilitated by psychologically trained practitioners. Using semi-structured interviews, nine multidisciplinary staff from four acute wards participated in the study. Grounded theory methodology was applied to investigate how staff experienced, processed, and operationalised psychological knowledge in their clinical practice. The results suggested staff increased their psychological understanding through a process of guided reflection, development of theory-practice links, and validation. This enhanced a capacity for mentalization, which generated a more compassionate and empathic stance. The clinical, theoretical and research implications are presented. Section C presents a critical appraisal of the research process.

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Clibbens, Nicola. "Registered nurses' and services users' expert views about therapeutic nursing on acute mental health wards." Thesis, University of Sheffield, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531209.

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Lloyd-Evans, B. "Acute inpatient mental health wards and inpatient alternatives : a quantitative comparison of the care provided." Thesis, University College London (University of London), 2010. http://discovery.ucl.ac.uk/19216/.

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Background: Literature indicates widespread dissatisfaction with UK acute psychiatric wards. Patients report boredom and insufficient time with staff. Residential alternatives to acute wards have been developed. Aims: 1) To review literature for the effectiveness and acceptability of alternatives 2) To identify or develop measures of content of care for acute inpatient and residential crisis services 3) To compare the content of care at alternatives and standard services and understand its relationship to patient satisfaction. Hypotheses tested were that alternatives provide greater total care, more social and psychological interventions but fewer physical and pharmacological interventions than standard wards. Method: A systematic review of studies evaluating alternatives was conducted. Measures of content of care were reviewed. New measures were developed (CaSPAR, CaRICE and CCCQ-P) and their psychometrics explored. Data were collected from 4 alternatives and 4 standard services using CaSPAR (n=224), CaRICE (1 recording week per service), CCCQ-P and CSQ (n=314). The relationship of service type, patient characteristics and CCCQ-P scores to patient satisfaction was explored. Results: The limited current evidence does not contra-indicate alternatives and suggests patient satisfaction may be greater at community alternatives than standard wards. No study hypotheses were corroborated. Sub-group analysis indicated community alternatives provided more psychological and less physical and pharmacological care than standard wards. All CCCQ-P variables were significantly associated with patient satisfaction. Patient satisfaction was greatest at community alternatives. It remained significantly greater at alternatives than standard wards after adjusting for CCCQ-P variables. Discussion: Community alternatives are a promising service model. Their greater acceptability than standard wards was not explained by measured differences in care. Intensity of care may influence patient satisfaction more than the types of intervention provided. Increasing staff-patient contact should be an aim for alternative and standard services. There may be differing, valid perspectives about what constitutes care: multi-methods assessment is required.

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McMullan, Elaine Catherine. "Experiences of staff working with voice hearers in acute mental health : an interpretative phenomenological approach." Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/8066/.

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Introduction: Staff in acute mental health settings work with voice hearers at times of crises, when experiencing high levels of distress. Research has demonstrated the importance of exploring the subjective experiences of voice hearing yet there has been little focus on staff experiences of working with voice hearers. The present study therefore sought to explore staff experiences of working with voice hearers in an acute mental health service. Method: Eight staff members (three mental health nurses and five healthcare support workers) from one acute mental health hospital were interviewed about their experiences of working with voice hearers. These interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Individual analyses were conducted for each participant before conducting a group analysis. Results: Three master themes and seven super-ordinate themes were identified from the group analysis. Participants described ‘struggling to exercise control’ in their work with voice hearers, moving from positions of ‘powerlessness’ to ‘feeling powerful’. Participants experienced the ‘emotional impact of the work’ to different intensities, often going through an initial ‘startling phase’ and transitioning to feelings of ‘performance anxiety and self-doubt’. ‘Ways of managing feeling overwhelmed’ were described including going through a ‘process of making sense’, ‘forming relationships’ with voice hearers and feeling a ‘sense of duty and responsibility’. Discussion: The present findings relate to power literature and previous research on empowerment and control in mental health services. A parallel process was identified between voice hearers and staff, both experiencing an initial ‘startling phase’ but transitioning to an ‘organisational phase’ where they make sense of their experiences. The research findings were also consistent with previous studies demonstrating staff anxiety around opening up conversations about the content of voices, highlighting staff training and support needs.

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Danzer, Graham. "Symptom severity upon admission and frequency of hospital readmission as predictors of medication adherence and length of stay for involuntary adults in an inpatient psychiatric facility." Thesis, Alliant International University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3714400.

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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.

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Ortiz, Marie Elois. "Educational Interventions to Improve Aggressive Behavior Recognition for an Acute Psychiatric Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4550.

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Nurses working in an acute psychiatric setting within a veterans' administration hospital must maintain a therapeutic milieu by recognizing and managing aggressive behaviors before violence ensues to reduce injuries to staff nurses and patients. The purpose of this project was to develop an evidence-based and theoretically grounded educational program that will help staff nurses manage escalating aggression, violence, and acting out behaviors to provide a safe environment for patients and staff through high risk identifier recognition and intervention training. During the data and information gathering stage, 23 articles were reviewed, rated, and graded to provide the most significant information used to complete the project. The project is a workshop made up of a 6-module curriculum that will be used to train staff nurses. This workshop will be shared with the partnering organization including the recommendation that it is adopted and implemented at a later date. The educational training program will have the potential to become a practice standard for other acute psychiatric settings within the Veterans Integrated Service Network to provide a tool that will assist the nurses as they care for the patient and maintain safety. Social change will occur through the empowerment of nurses who interact with veterans to bring them better and safer care.

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Horwood, Jo. "Standing up to be counted : an analysis of neighbourhood response to the siting of a mental health facility." Thesis, University of Portsmouth, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.478913.

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Caslin, Heather. "The Effect of Obesity on IL-1β, IL-1Ra, and Leptin Following Acute Mental Stress." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/600.

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Research regarding the development of cardiovascular disease (CVD) is important because CVD is the leading cause of death in the United States (US) and many countries abroad. Risk factors, such as obesity and psychological stress, should be studied in order to understand contributing factors for CVD and the cellular mechanisms which link risk factors with the development of disease. Specifically, the combined influence of multiple risk factors on inflammation is of interest because many individuals have more than one risk factor, which additively increases an individual’s risk for CVD. Obesity is already characterized by disordered inflammation, which suggests that the additional burden of a psychological stressor could elicit a greater inflammatory response and a greater risk for CVD than either stressor alone. The documents included within this thesis include the significance and specific aims of the study in addition to a review of the relevant literature related to the effects of obesity and acute mental stress (AMS) on endocrine and inflammatory markers. Specifically, this study aims to address IL-1β, IL-1Ra, and leptin following an AMS task in non-obese and obese individuals. Additionally, a manuscript is included which evaluates the change in IL-1β, IL-1Ra, and leptin following a 20 minute AMS task. Variables were examined between groups at baseline and at two time points following AMS. Additionally, the relationships among the changes in the markers following AMS were examined. Appendices include expanded methodology and all questionnaires used.

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Tam, Chiu-wan. "Community response to mental health facility : a study of objections to the setting up of a halfway house in Sun Chui Estate, Shatin /." [Hong Kong : University of Hong Kong], 1986. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12325909.

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Chater, Rachel. "Talking about acute inpatient mental health care : a qualitative analysis of service users', carers' and professionals' accounts." Thesis, University of East London, 2007. http://roar.uel.ac.uk/3807/.

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It was the aim of this study to develop a comprehensive understanding of acute inpatient mental health care. More specifically, the research questions focused on exploring how participants spoke about their experience of inpatient care and what opportunities there were to discuss and plan for discharge. It was also the aim of this study to examine multiple-perspectives (i.e. service users' carers' and professionals' perspectives) and consult service users with at least one previous experience of admission. Thematic analysis of the data was conducted, informed by ideas from discursive psychology. The recruitment of participants was partly determined by service users. Three service users were recruited, each of whom nominated a carer and professional to participate. A total of nine participants were recruited (three service users, three carers and three professionals). Each participant was interviewed separately, about their experiences of the acute inpatient mental health system. The interviews took place shortly after the discharge date. The results of this research, question the extent to which acute inpatient mental health services can deliver an adequate standard of care. In particular, this study highlighted how the hospital environment added to rather than alleviated service users' lack of clarity and their confusion following admission. The results also suggested that limited opportunities existed for service users to comfortably discuss their lack of understanding and ask questions. This study questioned to what extent the inpatient setting facilitated a genuine consultation of multiple perspectives, highlighting how decisions were often made about, but not with service users and significant others. Finally, the results of the analysis indicated that hospital was experienced as a chaotic, potentially violent, prison like environment in which therapeutic activities were limited and did not necessarily reflect service users' personal interests. The implications for research and practice were discussed.

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Dissertations / Theses on the topic 'Acute Mental Health Facility'

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