Dissertations / Theses on the topic 'Psychiatric hospital care South Australia'

Background: Enquiring about and documenting care arrangements for children of inpatient mothers with mental illness is paramount. Failure to do so could have a negative impact on the well-being of their children. Documenting care arrangements on admission signals good practice on the part of the admitting medical staff and ensures compliance with the requirements of the South African Children’s Act of 2004. This study explores the current practice at a large government run tertiary female inpatient psychiatric unit in Cape Town, regarding the enquiring and documenting practice within the first 24 hours of admission, of these care arrangements. Methods: The study is a cross sectional study using a mixed methods approach including: i) a case note audit of 100 consecutive patient folders examining the documentation of care arrangements within the first 24 hours of admission and ii) a structured self-administered questionnaire to professional staff working on the unit. Results: A total of 87 clinical folders were audited. Ninety nine percent of these folders had written down in them whether the women had children or not. Fifty eight percent of women had minor children and had 87 children between them. Fifteen percent of women had no care arrangements documented and 20% of women had unclear documentation of care arrangements. Fifteen completed staff questionnaires were returned. All staff agreed that it was important to ask the mothers about care arrangements. Conclusion: Significant more women that those identified on admission may have children who may have been in unsafe care arrangements at the time of their admission. There is room for improving the clarity of documenting of care arrangements and the enquiring into the specific care arrangements.

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: South Africa has transformed its mental health service provision from in-hospital care to community-based rehabilitation. Although the idea is sound, the process places the caregiving families under an immense pressure. The aim of this study was to explore the impact that the de-institutionalisation process has had on the families as they care for their child with intellectual disability. The study was conducted by means of qualitative, unstructured interviews with families that have had a child de-institutionalised from Alexandra Hospital in the Western Cape. All of the patients were diagnosed with a dual diagnosis of intellectual disability and mental illness. Even though the patients were in group-homes or attended a day care centre, final responsibility for the patients lay with the parents. Three main themes emerged from the interviews that describe the impact of deinstitutionalisation, viz. the characteristics of the family member with intellectual disability (aggressive, abusive and self-destructive behaviour of the patient), the effect that these characteristics had on the family (marital stress and health risks to the care giver), and community and resource factors. The study placed the family central to its environment and discussed the impact deinstitutionalisation had on its environment as a whole. It was concluded that the burden that de-institutionalisation places on the families far exceeded their ability to cope with these circumstances. This status quo could be improved if adequate resources and skills are given to families prior to de-institutional
AFRIKAANSE OPSOMMING: In Suid-Afrika is geestesgesondheidsorg van hospitaliserende na gemeenskapsgebaseerde rehabilitasie, omskep. Terwyl hierdie stap wel as lewensvatbaar mag voorkom, plaas die proses ‘n hewige las op die sorggewende gesin. Die doel van hierdie studie was om die omvang van die impak hiervan op ‘n gesin met ’n lid met intellektuele gestremdheid en psiegiatriese siekte, te bepaal – nadat so ‘n pasient uit die inrigting ontslaan is. Die ondersoek is uitgevoer by wyse van kwalitatiewe, ongestruktureerde onderhoude met gesinne wie se lede met die diagnose uitgeplaas is deur die Alexandra Hospitaal in die Wes-Kaap. Elkeen van die pasïente is gediagnoseer met ernstige intellektuele gestremdheid, asook bykomende gedragsafwykings. Ten spyte van die feit dat die betrokke pasïente deur groepshuise of dagsorg eenhede versorg word, bly hulle hul ouers se verantwoordelikheid. Drie temas het ontstaan wat die impak van ontslag uit die inrigting omskryf, te wete die karaktertrekke van die gestremde gesinslid (aggressie, misbruikende en vernielsugtige gedrag van die pasïent), die effek van hierdie karaktertrekke op die gesin (stres op die huwelik en potensiële gesondheidsrisiko wat dit vir die versorger inhou), en die gemeenskap en ondersteunende faktore. Tydens die ondersoek is die gesin sentraal geplaas ten opsigte van die omgewing. Die impak van ontslag van die gediagnoseerde pasïent uit die inrigting op die omgewing as geheel, word bespreek. Daar is tot die slotsom gekom dat die vermoë van die gesin wat die las moet dra as gevolg van die ontslag, ver oorspan word. Hierdie toedrag van sake sou egter verlig kon word indien toereikende hulpbronne en vaardighede aan sulke gesinne beskikbaar gestel word alvorens so ‘n pasïent ontslaan is.

This thesis examines the arts of care in an asylum in New South Wales (NSW) and a mental health community in the Australian Capital Territory in twentieth-century Australia, and describes and compares a range of governmental responses for responding to persons deemed to be in need of care. The thesis explores similarities between twentieth-century Australian care techniques and the key principles underpinning a ‘care system’ that was developed over 200 years ago. It proposes three twentieth-century care regimes, each one characteristic of a certain period: Herd Care, set in an asylum era that emphasised custodialism and confinement (1925-1958); Therapeutic Community, a period during which the asylum was reconfigured into a facilitative community (1959-1983); and Community Care, beginning around 1983, when NSW asylums were ‘rationalised’, their care techniques fragmented and outsourced in diverse settings generally referred to collectively as the mental health community. Some of the dynamics, continuities and ruptures in twentieth-century care regimes are analysed. Chapters describe the landscapes of care. They explore how environmental settings have been designed to reinforce the care regimes in which they are mobilised and how they ‘make up’ the possibilities for action of the subject of care. The dynamics of care between care providers and their recipients are examined. Some of the continuities and discontinuities of meanings associated with ‘family’ and ‘community’ in each of the care regimes are observed. Fieldwork findings are combined with the cultural narrative of psychiatric primitivism to consider why subjects have been deemed in need of care, at times in need of protection and training and at other times in need of discipline and restraint. The new possibilities for action that have emerged in Australian twentieth-century mental health governance are considered, when subjects of care have been encouraged to learn how to be free

Thesis (M.Med.(Psychiatry))--University of the Witwatersrand, Faculty of Health Sciences, 2014.
Introduction Absconding from psychiatric facilities has socioeconomic implications. The aetiology is multifactorial. Absconding patients are at higher risk of self-harm, violence, non-adherence, relapses, substance use and negative media attention. Identification of potential absconders would assist with risk assessment and prevention. Methods A retrospective record review was conducted of all absconds from a tertiary psychiatric hospital over one year. An abscond rate and a profile were formulated. In addition, trends were identified since the inception of democracy and deinstitutionalization. Results 97 patients absconded 108 times during the study period, 7 having absconded more than once. The absconding rate was 7.83%. The typical absconder is: single, unemployed male, in his early 30’s, known to psychiatric services, diagnosed with schizophrenia and co-morbid substance use. The typical absconder is more likely to be a forensic patient not returning from an official leave of absence. Conclusion The study defines the profile of the typical absconder. The abscond rate has decreased to half that of a previous study by Siwinska (1993). Mental health care users are being treated in a less restrictive manner and this results in less absconds and a change in the method of absconds. This has implications for clinical practice.

Within the framework of ethnography, an inquiry was made into the many dimensions of psychological treatment and training in a psychiatric hospital, with particular reference to State Patients. Ethnography is the study of an intact cultural or social group based mainly on observations over a prolonged period of time in which the researcher is a participant. The multicultural aspects of the therapeutic community were also inquired into. Ethnographic data was collected and processed over a period of 16 years in three psychiatric hospitals, the main source of data gathered from Weskoppies Hospital in Pretoria. The ecosystemic psychotherapeutic perspective was used as a meta-model to describe eight therapeutic approaches in which intern-psychologists were trained. The hospital is described as a therapeutic community in which rehabilitation is a multi-professional responsibility. Each profession, or sub-culture, has its own framework and culture in which it works within the broader system of the psychiatric hospital. Ethical considerations and recommendations are levelled at the academic and practical aspects of clinical psychology, hospital management, and different levels of government.
Psychology
D.Litt. et Phil.

The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members.
Health Studies
M.A. (Advanced Nursing Sciences)

"October 2004"
Includes bibliographical references (leaves 313-337)
x, 337 leaves : ill. (col.), maps (col.) ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2004

During the earliest days of the penal colony in New South Wales in 1788, the plight of the mentally ill was given little consideration by the governing authorities, particularly the convict insane, who lived (and died) by their wits and suffered cruel punishment if their behaviour was seen as recalcitrant. This thesis traces a history of mental health carers (nursing) from the foundation of the penal colony until the Federation of the Australian colonies to form a nation in 1901. The research makes a contribution to the profession of mental health nursing by providing an understanding of the origins and development of that profession in New South Wales. The thesis also examines ways in which the historic development of mental health nursing has influenced the work of mental health nurses and nursing in the present, and exposes recurrent dominant issues of the past which will, if they remain unaddressed, continue to influence that profession in the future.
Doctor of Philosophy (PhD)

Magister Curationis - MCur
Mental health care for adolescents is currently provided in a range of settings world-wide. These include the pediatrics units, general hospitals and specialized in-patient units for adolescents. However, care in these specialized units has hitherto not been evaluated. A phenomenological approach as a method and design was chosen to enable participants to describe and explore the lived experiences of nurses caring for adolescents in specialized psychiatric units of the selected psychiatric hospital. A purposive sampling method was used to select respondents. In-depth interviews were conducted with nurses caring for adolescents with mental health problems. Data saturation was reached with seven respondents. Interviews were recorded with a tape recorder that was only accessible to the researcher. Data analysis followed Collazi’s style that included listening to the recorded data, transcribing, coding, and intuition, reflection, reducing and interpreting the data. Ethical clearance was obtained from University of the Western Cape Higher Degrees Committee. The researcher requested permission to conduct the study at selected Psychiatric hospital from the Medical Superintendent and research ethics committee. Informed consent was also sought for those who agreed to participate in the study. Participants remained anonymous as their identity was not revealed. Only information related to the study was collected. Anonymity was assured by omitting names from transcripts as participants were given numbers only rather than using their names. The in-depth interviews were conducted in a quiet office to ensure privacy and confidentiality.

My interest in Palliative Care culminated last year in the opportunity of two placements in national and international reference centers. The Unidade de Cuidados Continuados e Paliativos has received me for two months and Southern Adelaide Palliative Services for three. These experiences allowed me to apply on practice the theory learned before and to develop diverse competences, such as: symptomatic control, psychosocial and spiritual approaches, communication with end-of-live patients and their families. During this period, I’ve been immersed in such different health systems, with diverse models of care, that inspired me for me future practice. I’ve had also the opportunity to participate in a research project with CareSearch, which aims to understand the role of the new figure in end-of-life area – death doula – as well as the reasons and context that ended in their appearance. This work made me reflect about the way we care for our patients, opposing to the way they wish to be treated and all the repercussions that this question raises. The statistical analysis is currently being performed and I look forward to contributing to the published article from my work.
O meu interesse em Cuidados Paliativos culminou no último ano na oportunidade de fazer dois estágios em centros de referência nacional e internacional. A Unidade de Cuidados Continuados e Paliativos recebeu-me durante um período de dois meses e os Southern Adelaide Palliative Services por um período de três meses. Estas experiências permitiram-me aplicar na prática a teoria já aprendida, desenvolvendo inúmeras competências, a salientar: controlo sintomático, abordagem psicossocial e espiritual, comunicação com doentes em fim de vida e suas famílias. Durante este período, consegui envolver-me em dois sistemas de saúde muito diferentes, com diferentes formas de cuidar, que me inspiraram para a minha prática futura. Tive ainda a oportunidade de participar num projeto de investigação em conjunto com o grupo CareSearch, com intuito de entender o papel da nova figura em cuidados paliativos – a doula de fim de vida – bem como os motivos e contextos que levaram ao seu aparecimento. Este trabalho fez-me refletir acerca da forma como cuidamos os doentes que tanto contrasta com a forma como eles desejariam ser cuidados e todas as implicações desta questão. A análise estatística está a ser efetuada, pelo que estou a aguardar poder contribuir para a publicação de um artigo acerca do trabalho que desenvolvi.

MCur
Department of Advanced Nursing Science
Nursing students’ absenteeism has become a very serious concern in every higher educational institution in the whole world especially those of nursing. This study was conducted to investigate factors leading to student nurses’ absenteeism in Limpopo College of Nursing during Psychiatric Nursing Science clinical placement. A quantitative approach using descriptive design was used. Purposive sampling method was used to get a sample of two hundred and six (206) of students who have absented themselves before. Data was collected through a self-report scale in the form of questionnaires of structured questions, entered and analysed using SPSS version 24. Ethical considerations were adhered to throughout. The correlation between clinical factors and absenteeism was determined. The main reported factors for absenteeism were: student nurses being treated as a workforce in the clinical areas; shortage of staff in the clinical areas; study for tests and examinations; inadequate supervision of student nurses by professional nurses; and being inconsiderate of student nurses request for days off in the clinical area. This study recommends that the college should make a provision of one week of study for student nurses between the period of clinical placement and tests or final examinations as most of the respondents indicated that they absent themselves due to study for tests and examinations. The Department of Health should find a way of not overworking students due to shortage of staff in the wards but consider them for experiential learning. A research study should be conducted to develop a model to reduce student nurses absenteeism.
NRF

MCur
Department of Advanced Nursing Science
Background: In South Africa the Mental Health Care Act No. 17 of 2002 direct district hospitals to render 72-hour assessment of the MHCU’s. In Vhembe district 72- hour assessment is implemented in public general hospital. Purpose: The study determined the experiences of family members regarding 72-hour assessment admission of MHCU’s at selected hospital in Vhembe District. Methodology: The research design was qualitative, exploratory, descriptive and contextual in nature. The study population consisted of the family members of the MHCU’s admitted for 72-hour assessment. Purposive sampling was used to select 10 family members. This study used in-depth individual interviews to collect data until data saturation was reached and analysed using Tesch’s steps. Ethical consideration and measures to ensure trustworthiness were given attention to throughout the study. Results: Three themes emerged from analysed data which is negative experiences of family’s members, family member’s experience on coping mechanism and structural constraints. Recommendations: This study recommends further research study on the development of a model to support the family members in their caregiving role The study recommends further research study on the experiences of the health care professional regarding 72-hour assessment of a MHCU’s
NRF