Strategies to facilitate community-based health care for severely and persistently mentally ill persons
- Authors: Shasha, Nontembeko Grycelda
- Date: 2015
- Subjects: Mentally ill -- Rehabilitation , Community mental health services , Community mental health services -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/3755 , vital:20461
- Description: The goal of mental health delivery system is to allow the individual with severe and persistent mental illness to live and function effectively in the community and to ensure that the consumers and their families have access to accurate information that promotes learning, self-monitoring and accountability (Stuart & Laraia, 2005:710). In community-based health care, the persons living with severe and persistent mental illness (SPMI) are in their natural environment in the context of the family and the community. The goals of care are focused around maximizing the person living with SPMI’s quality of life (Hunt, 2001:15-16). In South Africa, an integrated package of essential Primary Health Care (PHC) services has been made available to the entire population in order to provide the solid foundation of a single unified health care service (Department of Health, 2000:4). The assessment of health care needs of persons living with SPMI is a dynamic on-going process that is used to collect information, recognise changes, analyse needs and plan health care to provide baseline information to help evaluate the physiological and psychological normality and functional capacity of persons with SPMI (Hunt, 2001:100). There is insufficient information from the Department of Health to either satisfy the enquiry of whether the health care needs of persons living with SPMI are being met comprehensively or whether the practitioners rendering community-based health care are knowledgeable and comply with PHC norms and standards developed by this Department. The researcher is interested in understanding how the persons living with SPMI and their families experience the community-based health care provided by PHC nurses. The purpose of this research study is to develop strategies that would assist the PHC nurses in the selected rural areas of the Eastern Cape to facilitate community-based health care and to render a health care service relevant to the health care needs of the persons living with SPMI and their families. To achieve the objective of the study, the research design was based on a qualitative, exploratory, descriptive, contextual research approach. Phase one includes describing and selecting the research population and the sampling process prior to conducting the field work which comprises individual interviews with persons living with SPMI and their families as well as PHC nurses. According to Dickoff, James and Weidenbach (1968:422) and Chinn and Kramer (1995:78), this strategy involves identifying concepts from fieldwork and creating conceptual meaning to provide a foundation for developing strategies to facilitate community-based care for persons living with mental illness. Phase two of the research design will focus on development of conceptual framework in order to allow better understanding of the phenomenon of interest, as the major concepts will be simplified by connecting all related concepts together by means of statements. This was done by making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008:237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, applicable and relevant to the nursing practice have been developed for use by Department of Health and Primary Health Care to facilitate the multifaceted role of the PHC nurses.
- Full Text:
- Date Issued: 2015
- Authors: Shasha, Nontembeko Grycelda
- Date: 2015
- Subjects: Mentally ill -- Rehabilitation , Community mental health services , Community mental health services -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/3755 , vital:20461
- Description: The goal of mental health delivery system is to allow the individual with severe and persistent mental illness to live and function effectively in the community and to ensure that the consumers and their families have access to accurate information that promotes learning, self-monitoring and accountability (Stuart & Laraia, 2005:710). In community-based health care, the persons living with severe and persistent mental illness (SPMI) are in their natural environment in the context of the family and the community. The goals of care are focused around maximizing the person living with SPMI’s quality of life (Hunt, 2001:15-16). In South Africa, an integrated package of essential Primary Health Care (PHC) services has been made available to the entire population in order to provide the solid foundation of a single unified health care service (Department of Health, 2000:4). The assessment of health care needs of persons living with SPMI is a dynamic on-going process that is used to collect information, recognise changes, analyse needs and plan health care to provide baseline information to help evaluate the physiological and psychological normality and functional capacity of persons with SPMI (Hunt, 2001:100). There is insufficient information from the Department of Health to either satisfy the enquiry of whether the health care needs of persons living with SPMI are being met comprehensively or whether the practitioners rendering community-based health care are knowledgeable and comply with PHC norms and standards developed by this Department. The researcher is interested in understanding how the persons living with SPMI and their families experience the community-based health care provided by PHC nurses. The purpose of this research study is to develop strategies that would assist the PHC nurses in the selected rural areas of the Eastern Cape to facilitate community-based health care and to render a health care service relevant to the health care needs of the persons living with SPMI and their families. To achieve the objective of the study, the research design was based on a qualitative, exploratory, descriptive, contextual research approach. Phase one includes describing and selecting the research population and the sampling process prior to conducting the field work which comprises individual interviews with persons living with SPMI and their families as well as PHC nurses. According to Dickoff, James and Weidenbach (1968:422) and Chinn and Kramer (1995:78), this strategy involves identifying concepts from fieldwork and creating conceptual meaning to provide a foundation for developing strategies to facilitate community-based care for persons living with mental illness. Phase two of the research design will focus on development of conceptual framework in order to allow better understanding of the phenomenon of interest, as the major concepts will be simplified by connecting all related concepts together by means of statements. This was done by making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008:237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, applicable and relevant to the nursing practice have been developed for use by Department of Health and Primary Health Care to facilitate the multifaceted role of the PHC nurses.
- Full Text:
- Date Issued: 2015
Experiences of community psychiatric nurses and guardians of discharged psychiatric patients on the effectiveness of community mental health services of the Zomba district in Malawi
- Authors: Kachingwe, Bertha Maggie
- Date: 2011-12
- Subjects: Psychiatric nursing , Community mental health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24183 , vital:62440
- Description: Sturdy: Experiences of community psychiatric nurses and guardians of discharged psychiatric patients on the effectiveness of community mental health services of the Zomba District in Malawi. Purpose: The purpose of the study was to explore and describe the experiences of community psychiatric nurses and guardians of discharged psychiatric patients with regard to failure of Community Mental Health Services of the Zomba District, and make recommendations to improve community mental health services. Although such services exist, their effectiveness is unknown, either from the nurses’ point of view or from the consumers’ point of view. Method: A qualitative approach with phenomenological research design was used to answer the research question on the effectiveness of the services. This method was chosen because the researcher was committed to explore the lived in-depth experiences of the study participants. A purposive sampling method was used to select participants for the study, who were selected based on their knowledge of the phenomena. Data collection Instruments used were unstructured interviews, using face- to- face interaction. One broad, open-ended question was used to gather information from the participants. Data analysis was done using Atlas.ti software to help the researcher uncover complex phenomena hidden in the text. Findings: Participants from both groups overwhelmingly reported that community mental health services were not effective. Four categories and eleven themes of barriers impacting on ineffective services emerged from the nurses. For example; Inadequate service provision related to unavailability of resources (human, time and materials). Themes hindering effective services emerged from the guardians for example; Services not accessible related to inconsistent appointment dates, shortage of medications and poor economic status of participants. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- Date Issued: 2011-12
- Authors: Kachingwe, Bertha Maggie
- Date: 2011-12
- Subjects: Psychiatric nursing , Community mental health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24183 , vital:62440
- Description: Sturdy: Experiences of community psychiatric nurses and guardians of discharged psychiatric patients on the effectiveness of community mental health services of the Zomba District in Malawi. Purpose: The purpose of the study was to explore and describe the experiences of community psychiatric nurses and guardians of discharged psychiatric patients with regard to failure of Community Mental Health Services of the Zomba District, and make recommendations to improve community mental health services. Although such services exist, their effectiveness is unknown, either from the nurses’ point of view or from the consumers’ point of view. Method: A qualitative approach with phenomenological research design was used to answer the research question on the effectiveness of the services. This method was chosen because the researcher was committed to explore the lived in-depth experiences of the study participants. A purposive sampling method was used to select participants for the study, who were selected based on their knowledge of the phenomena. Data collection Instruments used were unstructured interviews, using face- to- face interaction. One broad, open-ended question was used to gather information from the participants. Data analysis was done using Atlas.ti software to help the researcher uncover complex phenomena hidden in the text. Findings: Participants from both groups overwhelmingly reported that community mental health services were not effective. Four categories and eleven themes of barriers impacting on ineffective services emerged from the nurses. For example; Inadequate service provision related to unavailability of resources (human, time and materials). Themes hindering effective services emerged from the guardians for example; Services not accessible related to inconsistent appointment dates, shortage of medications and poor economic status of participants. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- Date Issued: 2011-12
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