ETD Collection

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2013 - 20173

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Subject: search.filters.subject.Mental Health Services

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    The effects of including nurse-led cognitive behavioural therapy groups compared to a standard nursing programme for inpatients with mood disorders
    (2017) Visagie, Hester Maria Petronella
    Background: The delivery of cost effective quality mental health care services pose a significant challenge in the South African public sector due to limited resources and unequal access to specialised mental health care services. Professional mental health care nurses are well placed to provide psycho-social interventions, seeing that they play a vital role in the nursing care processes and as part of the multi-disciplinary inpatient treatment team. Cognitive behavioural therapy is described as the psychological therapy with the most solid evidence base pertaining to efficacy and effectiveness when treating mood disorders, specifically depressive disorders (Westbrook, Kennerley and Kirk, 2011:18). Anecdotal reports from patients and nursing personnel highlighted limited therapeutic interventions. Despite available evidence, cognitive behavioural group therapy does not form part of standard nursing care programmes in inpatient units for patients with mood disorders and depressive disorders. Aim and objectives: The purpose of the study was to examine whether nurse-led cognitive behavioural therapy groups in the standard nursing care programme would promote change in the core beliefs, coping behaviour and depressive symptoms of patients admitted to an inpatient unit for mood disorders and depressive disorders. The objectives were to: To obtain base-line data of the patient outcomes before and after the standard nursing programme; to compile appropriate measurable evidence based intervention for patients with mood disorders and depressive symptoms (Nurse-led Cognitive Behavioural Therapy Manual); examine whether statistically significant differences exist between the standard nursing programme and the nurse-led CBT nursing programme; assess the effectiveness of the nurse-led CBT group intervention programme and to discuss the field notes and supporting observations made during the intervention programme and recommendations for psychiatric nursing practice in the unit and future research. Method: A quantitative, quasi-experimental design was utilised (pre-test / post-test with a control group and experimental group). A non-probability convenient sampling method was used to select patients who were admitted with mood disorders and depressive symptoms from April 2015 to November 2015 (n=35) to participate in the study. One group (Control group, A) received the standard nursing programme and treatment as usual. Group (B) received the nurse-led cognitive behavioural group therapy sessions (experimental group). The validated and tested Beck Depression Inventory Scale - BDI was applied to assess and measure the existence and severity of depressive symptoms. The BDI scale consists of 21 iv questions and measured symptoms of depression according to categories relating to cognitive, affective, somatic and behavioural domains. Results: Although the statistically significant differences between groups were small and therefore could not be generalised to a larger population, the results were important for clinical practice. According to the findings of this study, there is a higher prevalence of mood disorders and depressive disorders amongst single, older and white Afrikaans-speaking females, which are not only important for practice but also for future planning and research. Relevance of the study: The results of this study showed that nurse-led cognitive behavioural (CBT) group sessions had positive effects on the patient‟s well-being by relieving the symptoms of depression and to provide the opportunity to develop life skills. Participation and facilitation of the nurse-led CBT groups‟ added value to professional mental health care nursing practice and the therapeutic milieu.
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    Identifying the understanding of mental illness of mental health care users of mixed ancestry group attending a community mental health clinic
    (2013-04-24) Ramanlal, Arunaben
    The purpose of this study was to elicit how mental health care users from a mixed ancestry group, otherwise called “Coloureds” at a Mental Health Clinic in an urban South African context, understood mental illness. “Coloured” peoples perceptions about mental illness in not well documented as few studies have addressed the needs of this population group in South Africa. The purpose was addressed within a closed questionnaire schedule using the Illness Perception Questionnaire - Mental Health, which was administered over a two month period, from 3rd June 2011 to 29th July 2011, using a non experimental, prospective, descriptive research design survey method. Data were collected by means of a self administered questionnaire and analysed by means of descriptive statistics. According to the statistician no confidence level was necessary as the instrument used was already tested to be valid and reliable. Since the study was descriptive, no comparative statistics were necessary.The analysed data revealed evidence of poor identification of mental illnesses. This could be a contributory factor to the inadequate adherence to treatment strategies and high re-hospitalization rates in this community. There was also a lack of collaboration between health workers and mental health care users and inadequate imparting of mental illness information by the mental health care practitioners. The positive results that have become evident in this study of good community support, good personal control of illness, a belief in the importance of taking medication and low stress levels, may be utilized effectively to empower this community with knowledge about mental illness. This may allow this community to assume responsibility and be supportive in the efforts to destigmatise mental illness and to ensure that community mental health care services move efficiently and effectively.