scholarly journals From alienation to the nursing clinic: care of patients with psychiatric comorbidity

2018 ◽  
Vol 71 (suppl 5) ◽  
pp. 2229-2236
Author(s):  
Talita Rodrigues Nicacio ◽  
Vanessa Pellegrino Toledo ◽  
Ana Paula Rigon Francischetti Garcia

ABSTRACT Objective: to understand how nurses of mental health care for psychiatric patients with clinical comorbidities. Method: qualitative study based on the referential of historical and dialectical materialism. Interviews with nurses were conducted using semi-structured script. Sample determined in snowball. The interviews were recorded and transcribed in full. The data were analyzed through content analysis, including: organization and exhaustive reading of the material, exploration, grouping data into thematic units, processing of results, and interpretation. Results: the role of nurses is marked by the dialectic between knowing and not knowing, a movement that revealed two categories: clinic of psychiatric nursing, and alienation and subordination of nurse in the care process. Final considerations: the development of the nursing clinic, based on the therapeutic relationship, favors integral care towards the patient, whereas alienation/subordination distances the nurse from care and impairs care.

1996 ◽  
Vol 3 (3) ◽  
pp. 202-211 ◽  
Author(s):  
Kim Lützén ◽  
António Barbosa da Silva

The main purpose of this article is to discuss the place of the ethics of virtues and char acter in nursing and health care in general, and in psychiatric nursing in particular. To attain this goal, the relationship between the ethics of duty (i.e. rule based ethics) and the ethics of virtue and character will be clarified in order to defend our main hypothe sis that these two types of ethics should complement each other, since both are necessary but neither by itself is sufficient for nursing. This means that any applied ethics, as in nursing, should consider the importance of the agent's moral character. To support our arguments, we shall use cases from the empirical reality of psychiatric and mental health care.


2016 ◽  
Vol 47 (1) ◽  
pp. 97-109 ◽  
Author(s):  
Xanthe Hunt ◽  
Leslie Swartz

We examine the extent to which psychotherapy can be successfully conducted with the aid of an interpreter. We propose that, even if we assume idealistic levels of training on the part of the interpreter and the therapist, and openness on the part of the client, there are still many challenges inherent in interpreter-assisted therapy. We focus on some of the characteristics common to client experiences of effective psychotherapy, as well as the characteristics and habits of effective therapists, and show how the insertion of an interpreter into the therapeutic relationship could affect both. Where the literature provides, we also note steps which could be taken to minimise the harmful impacts and maximise the positive contributions which the therapist–interpreter–client dynamic could yield. In South Africa, where informal interpreters play the invaluable role of facilitating essential communication between psychotherapists and their clients, it is imperative that informal interpreters, and clinicians working with interpreters, are aware of some of the complex issues at play in interpreted interactions. The issue of interpreting in mental health care is commonly addressed only in regard to the question of the competence of interpreters; we suggest that attitudinal and skill issues are equally important for clinicians. We conclude that successful therapy with an interpreter necessitates a consideration of the dynamic interaction between all parties involved.


2012 ◽  
Vol 28 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Sabine Loos ◽  
Reinhold Kilian ◽  
Thomas Becker ◽  
Birgit Janssen ◽  
Harald Freyberger ◽  
...  

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.


2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Carlon Washington Pinheiro ◽  
Michell Ângelo Marques Araújo ◽  
Karla Maria Carneiro Rolim ◽  
Camila Moreira De Oliveira ◽  
Alexsandro Batista De Alencar

Objetivo: Refletir teoricamente sobre a importância da Teoria das Relações Interpessoais de Peplau, contextualizada com o processo de formação da identidade do enfermeiro como terapeuta em saúde mental e psiquiatria. Metodologia: A partir do estudo da obra sobre Relações Interpessoais em Enfermagem de Peplau e demais textos, a reflexão organizou-se em três eixos: a teoria das relações interpessoais, a relação terapêutica na teoria de Peplau e o subpapel de assessor/counseling. Resultados: Os três eixos foram detalhados, aliando as contribuições da literatura, com novas possibilidades de aplicação do arcabouço teórico. Conclusão: A Teoria das Relações Interpessoais com foco no conceito de counseling possibilita reflexões sobre a representação do enfermeiro como terapeuta e fortalece ações de enfermagem no contexto do cuidado em saúde mental.Descritores: Enfermagem; Enfermagem Psiquiátrica; Teoria de Enfermagem; Saúde Mental.THEORY OF INTERPERSONAL RELATIONS: REFLECTIONS ON THE THERAPEUTIC FUNCTION OF THE NURSE IN MENTAL HEALTHObjective: To reflect theoretically on the importance of Peplau's Theory of Interpersonal Relations, contextualized with the process of formation of the nurse's identity as a therapist in mental health and psychiatry. Methodology: From the study of Peplau's work on Interpersonal Relations in Nursing and other texts, the reflection was organized in three axes: the theory of interpersonal relations, the therapeutic relationship in Peplau's theory and the counseling sub-role. Results: The three axes were detailed, combining the contributions of the literature, with new possibilities of application of the theoretical framework. Conclusion: The Theory of Interpersonal Relations focusing on the concept of counseling enables reflections on the representation of nurses as therapists and strengthens nursing actions in the context of mental health care.Descriptors: Nursing; Psychiatric Nursing; Nursing theory; Mental Health.TEORÍA DE LAS RELACIONES INTERPERSONALES: REFLEXIONES ACERCA DE LA FUNCIÓN TERAPÉUTICA DEL ENFERMERO EN SALUD MENTALObjetivo: Reflexionar teóricamente sobre la importancia de la Teoría de las Relaciones Interpersonales de Peplau, contextualizada con el proceso de formación de la identidad del enfermero como terapeuta en salud mental y psiquiatría. Metodología: A partir del estudio del trabajo de Peplau sobre las relaciones interpersonales en enfermería y otros textos, la reflexión se organizó en tres ejes: la teoría de las relaciones interpersonales, la relación terapéutica en la teoría de Peplau y el sub-rol de asesor/consejero. Resultados: Los tres ejes fueron detallados, combinando las contribuciones de la literatura, con nuevas posibilidades de aplicación del marco teórico. Conclusión: La teoría de las relaciones interpersonales, centrada en el concepto de asesoramiento, permite reflexionar sobre la representación de las enfermeras como terapeutas y fortalece las acciones de enfermería en el contexto de la atención de la salud mental.Descriptores: Enfermería, Enfermería Psiquiátrica, Teoría de Enfermería, Salud Mental.


2021 ◽  
pp. 030802262110181
Author(s):  
Megan L Howes ◽  
Diane Ellison

Introduction There is recognition within the literature that the role of care-giving can have a negative impact on care-givers’ general well-being. Less is understood about the role of care-giving on an individual’s occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. Method A qualitative semi-structured interview the Occupational Performance and History Interview–Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Findings Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. Conclusion The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.


Author(s):  
Debanjan Banerjee ◽  
Kiran Rabheru ◽  
Carlos Augusto de Mendonca Lima ◽  
Gabriel Ivbijaro

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.


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