Abstract
D.Cur. ( Psychiatric Nursing)
A marked "revolving door" system is noticeable in health services in South Africa,
and the more so in psychiatric services. This is happening in the form of psychiatric
patients who are repeatedly being readmitted to psychiatric hospitals for the same
or related problem. In most cases this is caused by the psychiatric patients' lack
of compliance with the psychiatric treatment prescribed for them once they have
been released back into the community.
Lack of compliance by the psychiatric patients with their treatment means that the
treatment that is prescribed to help the patient to function in the community, is not
congruent with his/her life ways, social structure and environmental context. These
are the components of everyone's culture, and they determine the psychiatric
patients' cultural beliefs, values and practices, including those concerning mental
health care.
The purpose of this research study is to explain and describe the influence of
culture on approaches to mental illness and the patients' compliance with
psychiatric treatment, to generate a practice model for culture-congruent
psychiatric nursing and guidelines for a culture-congruent approach in
psychiatric nursing. The Nursing for the Whole Person Theory was used as the
paradigmatic framework of the entire study. The research study followed three
distinct phases in which different objectives were addressed. In Phase 1, an
explanatory-descriptive study was conducted for the purpose of compiling
explanatory case studies reflecting cultural approaches to mental illness and the
patients' compliance with psychiatric treatment. The sample population consisted
of four psychiatric patients randomly selected from four different long-term wards
at the same psychiatric hospital, a group of psychiatric nurses nursing these
patients, and the psychiatrists treating these patients, making a total of 22
respondents.
Literature was first reviewed on the interrelationships among world view, culture,
health beliefs, values and practices, approaches to mental illness and the patients'
compliance with psychiatric treatment. The information obtained from literature
review was utilized to compile guidelines for explanatory case studies. The
explanatory case studies were compiled for each of the four psychiatric patients
based on information from interviews, field notes and the patients' clinical...