A model to facilitate the mental health of student nurses working with mentally challenged individuals
- Janse van Rensburg, Elsie Sophia
- Authors: Janse van Rensburg, Elsie Sophia
- Date: 2014-03-18
- Subjects: Nursing students - Mental health , Psychiatric nurses - Mental health , Psychiatric nursing - Psychological aspects , Psychiatric nurses - In-service training
- Type: Thesis
- Identifier: uj:4438 , http://hdl.handle.net/10210/9781
- Description: D.Cur. (Psychiatric Nursing Science) , The researcher was involved in the clinical accompaniment of student nurses working with mentally challenged individuals during their psychiatric nursing practical training. In her role as advanced psychiatric nurse educator, she noticed that student nurses experienced working with mentally challenged individuals as a challenging working context. It created intense emotional discomfort for the student nurses, especially during their initial exposure to the relevant individuals. During the student nurses' last day of working with these individuals, they reflected with the advanced psychiatric nurse educator on their emotional growth and enrichment and how this experience had changed their views of life. Ineffective management of emotional discomfort may lead to emotional exhaustion or burnout and reflect negatively on a person's mental health. The main purpose of this research was to explore and describe the experiences of student nurses working with mentally challenged individuals. Subsequently, to develop, describe and write guidelines to operationalise and evaluate a model for the advanced psychiatric nurse educator to facilitate the mental health of student nurses working with mentally challenged individuals. A qualitative, explorative, descriptive, contextual and theory-generating research design was utilised to achieve the abovementioned purpose. The development of the model comprised four steps. Step one consisted of a concept analysis including identification and definition of central concepts in the model. A concept analysis was done by exploring and describing the experiences of student nurses working with mentally challenged individuals. Two focus groups, naive sketches, reflective journals, a reflective letter and field notes were used to explore their experiences. Focus groups were audiotaped as well as videotaped. Verbal consent was given by the student nurses to be videotaped and a letter of consent was signed to give permission for audiotaping of the focus groups. The audio tapes were transcribed verbatim. The video tapes were only used by the transcriber when she could not hear the sound on the audio tapes clearly. An independent coder utilised Tesch's method of open-coding to code and analyse the data. A consensus was reached between the researcher and the independent coder with regard to the themes and catogories represented by the data. During the concept analysis, engagement on a deeper emotional level was identified as the central concept. Step two consisted of the relationship statements of the model. During step three, a model for the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals was described. The structure of the model clarified the purpose, assumptions and context. The central concepts were defined and the relationship statements between the central and essential concepts were explained. The structure of the model focused on the relationship-, workingand termination phases within the process of engagement on a deeper emotional level. In step four guidelines were described to operationalise the model in practice. The model, as framework of reference for the advanced psychiatric nurse educator, focused on the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals. The process description of the model differentiated between three phases: the relationship phase, the working phase and the termination phase. Guidelines for the operasionalisation of the model focused on the objective of each phase as well as the strategy of actions for each different phase.
- Full Text:
- Authors: Janse van Rensburg, Elsie Sophia
- Date: 2014-03-18
- Subjects: Nursing students - Mental health , Psychiatric nurses - Mental health , Psychiatric nursing - Psychological aspects , Psychiatric nurses - In-service training
- Type: Thesis
- Identifier: uj:4438 , http://hdl.handle.net/10210/9781
- Description: D.Cur. (Psychiatric Nursing Science) , The researcher was involved in the clinical accompaniment of student nurses working with mentally challenged individuals during their psychiatric nursing practical training. In her role as advanced psychiatric nurse educator, she noticed that student nurses experienced working with mentally challenged individuals as a challenging working context. It created intense emotional discomfort for the student nurses, especially during their initial exposure to the relevant individuals. During the student nurses' last day of working with these individuals, they reflected with the advanced psychiatric nurse educator on their emotional growth and enrichment and how this experience had changed their views of life. Ineffective management of emotional discomfort may lead to emotional exhaustion or burnout and reflect negatively on a person's mental health. The main purpose of this research was to explore and describe the experiences of student nurses working with mentally challenged individuals. Subsequently, to develop, describe and write guidelines to operationalise and evaluate a model for the advanced psychiatric nurse educator to facilitate the mental health of student nurses working with mentally challenged individuals. A qualitative, explorative, descriptive, contextual and theory-generating research design was utilised to achieve the abovementioned purpose. The development of the model comprised four steps. Step one consisted of a concept analysis including identification and definition of central concepts in the model. A concept analysis was done by exploring and describing the experiences of student nurses working with mentally challenged individuals. Two focus groups, naive sketches, reflective journals, a reflective letter and field notes were used to explore their experiences. Focus groups were audiotaped as well as videotaped. Verbal consent was given by the student nurses to be videotaped and a letter of consent was signed to give permission for audiotaping of the focus groups. The audio tapes were transcribed verbatim. The video tapes were only used by the transcriber when she could not hear the sound on the audio tapes clearly. An independent coder utilised Tesch's method of open-coding to code and analyse the data. A consensus was reached between the researcher and the independent coder with regard to the themes and catogories represented by the data. During the concept analysis, engagement on a deeper emotional level was identified as the central concept. Step two consisted of the relationship statements of the model. During step three, a model for the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals was described. The structure of the model clarified the purpose, assumptions and context. The central concepts were defined and the relationship statements between the central and essential concepts were explained. The structure of the model focused on the relationship-, workingand termination phases within the process of engagement on a deeper emotional level. In step four guidelines were described to operationalise the model in practice. The model, as framework of reference for the advanced psychiatric nurse educator, focused on the facilitation of a process of engagement on a deeper emotional level for student nurses working with mentally challenged individuals. The process description of the model differentiated between three phases: the relationship phase, the working phase and the termination phase. Guidelines for the operasionalisation of the model focused on the objective of each phase as well as the strategy of actions for each different phase.
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A model for psychiatric nurses to facilitate the mental health of adolescents abusing substances
- Authors: Rikhotso, Tinyiko Nelly
- Date: 2019
- Subjects: Psychiatric nurses - In-service training , Teenagers - Mental health , Teenagers - Substance abuse , Adolescent psychiatry
- Language: English
- Type: Doctoral (Thesis)
- Identifier: http://hdl.handle.net/10210/457359 , uj:40580
- Description: Abstract: 1.1 INTRODUCTION The use and abuse of substances, especially among the youth, continues to be a serious concern within the international community. Not only does this affect them as individuals, but also their families, the community in which they live and the society at large. This is evident when such practices cause social and family disorganisation, economic instability, social insecurity, and curb progress for individuals, families and the state. Some effort towards intervening on this challenge has and still continues to exist, yet it appears it is not enough. There are some shortfalls in terms of interventions as there is no satisfying improvement; instead, the prevalence of substance abuse is becoming worse each day (Chakravarthy, Shah & Lotfipour, 2013:1022). Findings from a study conducted by the researcher for a minor dissertation (Rikhotso, 2008:41-64) indicate that adolescents who abuse substances experience a range of emotional, physical, academic and social setbacks and challenges. Adolescents engage in substance abuse activities in response to internal and external drives. At this developmental stage, an individual has to make life choices, including the choice of friends and lifestyle. In the process of doing this, people may find themselves engaging with bad company that tunes them into taking substances which later cause addiction. This goes as far as wanting to belong to a particular group steered by peer pressure. Parental modelling and values are other contributory causes leading to adolescents abusing substances. For example, parents who practice Rastafarian religion (Rikhotso, 2008:42) smoke marijuana as a religious activity and expect their children to do the same. Some adolescents are driven by their own curiosity to explore and know things around them. They want to taste and feel what others are feeling when they use different types of substances which are portrayed to them as good feelings. They also initiate their own means to obtain these substances like stealing money 2 from their parents, accumulating pocket money until they can afford to buy substances of their choice, and sometimes getting those substances through friends (sharing) (Rikhotso, 2008:41). Other adolescents reach a stage where they realise that what they are doing is not good and detrimental to their future. They then consider quitting the use of substances, but fail. Reasons for their failure include fear of rejection by their peers, fear of victimisation and failure to obtain alternative means to address their emotional and social challenges (Rikhotso, 2008:49). Little do they know that the more they abuse substances, the more these challenges build up and become more intense and uncontrollable. The effects of substance abuse include effects on volition where adolescents lacked the willpower to decide what action to take in a given situation. On the other hand, they were also affected psychologically as evidenced by feelings of guilt, worthlessness, hopelessness, alienation and many more. Their relationships were at stake as they were rejected by their friends, siblings feared them and they were deserted by their parents (Rikhotso, 2008:50). However, these adolescents’ experiences of substance abuse kept them motivated and burning to discontinue abusing substances; most even made plans on how they would do it. It is based on these findings that the researcher identified a gap and a need to assist these adolescents, hence the idea of developing a model in this study. Some interventions which the focused on promotive and preventive health were cited in another study (Salam, Das, Lassi & Bhutta, 2016:06) and these included the promotion of sexual and reproductive health, nutrition interventions, immunisation, mental health promotion, substance abuse prevention and prevention of unintended injuries. Giovazolias and Themeli (2014:72-73) conducted a case study on a 17-year old boy who was abusing substances which led to altered behaviour and unhealthy relationships. Their findings included enhancement of communication skills, pointing out the consequences of untoward behaviour, minimising associations with substances, using a stimulating environment, training to improve resistance skills, and controlling procedures to assist in reducing the desire to engage in substance use. Progressively, there was a marked improvement as far as behaviour, relating to others and reduction in the level of substance use... , D.Cur. (Psychiatric and Mental Health Nursing)
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- Authors: Rikhotso, Tinyiko Nelly
- Date: 2019
- Subjects: Psychiatric nurses - In-service training , Teenagers - Mental health , Teenagers - Substance abuse , Adolescent psychiatry
- Language: English
- Type: Doctoral (Thesis)
- Identifier: http://hdl.handle.net/10210/457359 , uj:40580
- Description: Abstract: 1.1 INTRODUCTION The use and abuse of substances, especially among the youth, continues to be a serious concern within the international community. Not only does this affect them as individuals, but also their families, the community in which they live and the society at large. This is evident when such practices cause social and family disorganisation, economic instability, social insecurity, and curb progress for individuals, families and the state. Some effort towards intervening on this challenge has and still continues to exist, yet it appears it is not enough. There are some shortfalls in terms of interventions as there is no satisfying improvement; instead, the prevalence of substance abuse is becoming worse each day (Chakravarthy, Shah & Lotfipour, 2013:1022). Findings from a study conducted by the researcher for a minor dissertation (Rikhotso, 2008:41-64) indicate that adolescents who abuse substances experience a range of emotional, physical, academic and social setbacks and challenges. Adolescents engage in substance abuse activities in response to internal and external drives. At this developmental stage, an individual has to make life choices, including the choice of friends and lifestyle. In the process of doing this, people may find themselves engaging with bad company that tunes them into taking substances which later cause addiction. This goes as far as wanting to belong to a particular group steered by peer pressure. Parental modelling and values are other contributory causes leading to adolescents abusing substances. For example, parents who practice Rastafarian religion (Rikhotso, 2008:42) smoke marijuana as a religious activity and expect their children to do the same. Some adolescents are driven by their own curiosity to explore and know things around them. They want to taste and feel what others are feeling when they use different types of substances which are portrayed to them as good feelings. They also initiate their own means to obtain these substances like stealing money 2 from their parents, accumulating pocket money until they can afford to buy substances of their choice, and sometimes getting those substances through friends (sharing) (Rikhotso, 2008:41). Other adolescents reach a stage where they realise that what they are doing is not good and detrimental to their future. They then consider quitting the use of substances, but fail. Reasons for their failure include fear of rejection by their peers, fear of victimisation and failure to obtain alternative means to address their emotional and social challenges (Rikhotso, 2008:49). Little do they know that the more they abuse substances, the more these challenges build up and become more intense and uncontrollable. The effects of substance abuse include effects on volition where adolescents lacked the willpower to decide what action to take in a given situation. On the other hand, they were also affected psychologically as evidenced by feelings of guilt, worthlessness, hopelessness, alienation and many more. Their relationships were at stake as they were rejected by their friends, siblings feared them and they were deserted by their parents (Rikhotso, 2008:50). However, these adolescents’ experiences of substance abuse kept them motivated and burning to discontinue abusing substances; most even made plans on how they would do it. It is based on these findings that the researcher identified a gap and a need to assist these adolescents, hence the idea of developing a model in this study. Some interventions which the focused on promotive and preventive health were cited in another study (Salam, Das, Lassi & Bhutta, 2016:06) and these included the promotion of sexual and reproductive health, nutrition interventions, immunisation, mental health promotion, substance abuse prevention and prevention of unintended injuries. Giovazolias and Themeli (2014:72-73) conducted a case study on a 17-year old boy who was abusing substances which led to altered behaviour and unhealthy relationships. Their findings included enhancement of communication skills, pointing out the consequences of untoward behaviour, minimising associations with substances, using a stimulating environment, training to improve resistance skills, and controlling procedures to assist in reducing the desire to engage in substance use. Progressively, there was a marked improvement as far as behaviour, relating to others and reduction in the level of substance use... , D.Cur. (Psychiatric and Mental Health Nursing)
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