ABSTRACT
Sexuality is a vital component of the self. Yet, there is a dearth of research literature that explores the sexuality of people with schizophrenia. The purpose of this study was to understand how people with schizophrenia experience and perceive their sexuality. Using grounded theory methodology, the study recruited five men and five women with schizophrenia-spectrum disorders who lived independently in the community. These participants were interviewed regarding their subjective sense of their own sexuality. The findings suggested that people with schizophrenia integrate sexuality into their sense of self. Although the illness affected various aspects of their sexual lives, many participants were able to develop and maintain meaningful intimate relationships, as well as construct their own definitions and personal meanings of sexuality. Furthermore, participants described dealing with the impact of schizophrenia in the context of managing their illness. These findings have implications for clinical practice and recovery of people with schizophrenia.
Subject(s)
Schizophrenic Psychology , Sexuality , Female , Humans , Male , Outpatients , Self ConceptABSTRACT
1. Both clinicians and consumers identified the importance of maintaining relationships and experiencing success as helpful in building and nurturing hope for consumers. 2. To provide holistic care, clinicians need to discuss spirituality and meaning with clients. 3. Because being hopeful is an active process, clinicians need to talk to clients about hope, openly, realistically, and strategically.
Subject(s)
Adaptation, Psychological , Attitude to Health , Morale , Schizophrenic Psychology , Adult , Female , Goals , Humans , Internal-External Control , Male , Middle Aged , Needs Assessment , Nursing Methodology Research , Professional-Patient Relations , Religion and Psychology , Self Concept , Social Support , Surveys and QuestionnairesABSTRACT
An educational game was developed to promote student problem solving in the context of small group, problem-based learning (PBL). This study evaluated the game's effects on hypothesis and issue generation in PBL. Students in the Year III PBL course of a BScN program (N = 131) were stratified by program status and then randomly assigned to groups of 9 to 11 people per group. Half of the groups were randomly assigned to use the game (G); the remaining groups used the conventional method (CM) of generating issues and hypotheses. The G and CM groups crossed over for Term II. A Term I posttest demonstrated G groups had a higher proportion of accurate responses (85%) than CM groups (74%). A Term II posttest demonstrated no important differences between G and CM groups, suggesting the educational impact of the game persisted after students stopped using it. Strengths and limitations of the game as a learning aid also are addressed.
Subject(s)
Education, Nursing, Baccalaureate/methods , Problem-Based Learning/methods , Adult , Analysis of Variance , Cross-Over Studies , Educational Status , Female , Humans , MaleABSTRACT
This qualitative study identifies factors that influence staff hopefulness in their work with individuals with schizophrenia. Fifteen mental health professionals from both inpatient and community settings were interviewed via a semi-structured questionnaire. Subjects described the following as important to their hopefulness: knowing clients as people, sharing client successes, and receiving recognition for their accomplishments. Several educational, research, and system issues were also identified as influencing hopefulness. Respondents also described barriers to hopefulness arising from clients, coworkers and public attitudes. The relevance of these findings to promoting hopeful working environments is discussed.
Subject(s)
Attitude of Health Personnel , Health Personnel/psychology , Morale , Schizophrenia/therapy , Female , Humans , Job Satisfaction , Male , Nursing Methodology Research , Organizational Culture , Prognosis , Schizophrenic Psychology , Surveys and Questionnaires , WorkplaceABSTRACT
Nurses have many opportunities to assist individuals with schizophrenia because of the frequency and nature of their contacts. The nurses in this study believed that they can make a difference and can identify hope-instilling strategies. Strategies for rehabilitation include assisting persons with schizophrenia to set goals, seeing them as people, and joining with them on their journey of recovery. Recognizing that the establishment of the relationship is central in assisting the development of client hope, and (hopefully) eventual recovery, may help nurses to persevere despite what may be a challenging and lengthy process.
Subject(s)
Motivation , Patient Care Team , Psychotherapy/methods , Schizophrenia/therapy , Schizophrenic Psychology , Adaptation, Psychological , Goals , Humans , Nurse-Patient Relations , Psychiatric Status Rating Scales , Quality of LifeABSTRACT
This study explores the use of journals to identify important issues facing nursing students when learning in a psychiatric setting. During a 13-week psychiatric clinical experience, 18 third-year students kept journals describing the most significant event that occurred each week, reflecting on the impact and accompanying attitudes of that event. Throughout the clinical experience, the nursing faculty read the students' journals and provided written feedback on a bi-weekly basis. Major themes that students wrote about in their journals were identified. These included: meaningful learning, issues of the novice, relationships, control, self-reflection, and identification with clients. Keeping a journal provided the students with an opportunity to become more self-reflective in their practice. The issues identified by students in their journals may assist nurse educators to anticipate the learning needs of their students in psychiatry.
Subject(s)
Psychiatric Nursing/education , Self Disclosure , Students, Nursing/psychology , Female , Humans , Internal-External Control , Nurse-Patient Relations , Nursing Research/methodsABSTRACT
1. A person with mental illness, such as schizophrenia, can be mobilized to maintain hope. 2. A relationship seems to be the catalyst that allows hope to develop exponentially. 3. A belief in the client's abilities can be a powerful motivator for change.
Subject(s)
Motivation , Nurse-Patient Relations , Schizophrenia/nursing , Schizophrenic Psychology , Adult , Family/psychology , Female , Goals , Humans , PsychotherapyABSTRACT
The practical concerns of well siblings of persons with schizophrenia were examined in a descriptive study that included a needs assessment survey and a workshop designed to increase well siblings' knowledge about schizophrenia. A questionnaire focusing on needs for information, support, and practical skills was completed by 88 well siblings and 19 of their spouses. The results indicated a desire for more specific information about schizophrenia, particularly prognosis, and difficulties in communicating and problem solving with siblings with schizophrenia. Although respondents to the questionnaire were neutral about the need for support from other well siblings, participants at the workshop indicated that they found the opportunity to meet and share experiences with other well siblings to be the workshop's strongest feature. The study indicates that well siblings of persons with schizophrenia have specific needs that may differ from those of other family members.
Subject(s)
Defense Mechanisms , Schizophrenia/rehabilitation , Schizophrenic Psychology , Sibling Relations , Activities of Daily Living/psychology , Adult , Family Therapy , Female , Humans , Male , Marriage/psychology , Patient Education as TopicABSTRACT
Personal attitudes and self-awareness are key issues of which the psychiatric nursing student must be aware when establishing a therapeutic relationship. Facilitating awareness and growth in these areas are fundamental challenges for the nurse educator. One potential teaching strategy with which to address this issue is journal keeping. This paper describes a study evaluating the impact of journal keeping on student nurses' attitudes toward psychiatric clients and self-awareness in relations with others. Third-year nursing students completing a psychiatric rotation kept journals which were used to reflect on thoughts and feelings engendered by their clinical experience. Two student control groups were used: one completing a psychiatric rotation without keeping journals and the second completing a medical-surgical rotation. All students completed the Opinions About Mental Illness, the Fundamental Interpersonal Relations Orientation-Behaviour, and Comfort in Working with Psychiatric Clients Scales prior to and at the end of their clinical experience. Findings support the use of journals to assist students in exploring and changing their attitudes but not necessarily in changing their interpersonal style.
Subject(s)
Psychiatric Nursing/education , Students, Nursing/psychology , Teaching/methods , Writing , Adult , Attitude to Health , Education, Nursing, Baccalaureate/methods , Education, Nursing, Baccalaureate/standards , Female , Humans , Internal-External Control , Male , Nurse-Patient Relations , Nursing Education Research , Self Concept , Teaching/standardsABSTRACT
Unified service systems for the chronic mentally ill are frequently proposed yet rarely implemented. This paper presents a program developed specifically to meet the needs of young people with schizophrenia and their families. The program's evolution and design, from its origins in a hospital to its eventual base in the community, are described. The implications of a clinical teaching unit affiliated with a university are outlined. The experience of a typical patient and his family provides a view from a clinical context. Hypotheses arising from this case study point to future empirical work in the development of model programs in the care of the long term mentally ill.
Subject(s)
Community Mental Health Services , Hospitalization , Schizophrenia/rehabilitation , Schizophrenic Psychology , Activities of Daily Living/psychology , Adult , Chronic Disease , Combined Modality Therapy , Continuity of Patient Care , Humans , Male , Ontario , Patient Care TeamABSTRACT
Four patients with pyoderma gangrenosum were treated with hyperbaric oxygen to prepare the wounds for skin grafting. Each wound responded to a course of daily hyperbaric oxygen with reduction of infection and increased capillary angiogenesis. During follow-up periods of 12 to 30 months, all wounds remained healed. Although the exact etiology of pyoderma gangrenosum is unknown, vasculitis with wound ischemia and infection are prominent components. Inspired oxygen partial pressures of 1100 to 1300 mmHg elevate wound oxygen tension despite relative ischemia. The impaired intracellular bacterial killing of hypoxic leukocytes is corrected during each day's 2-hour bolus of hyperbaric oxygen. Daily wound oxygenation increases collagen production by fibroblasts to support capillary angiogenesis.
Subject(s)
Hyperbaric Oxygenation , Pyoderma/surgery , Skin Transplantation , Skin Ulcer/surgery , Surgery, Plastic/methods , Adolescent , Adult , Female , Follow-Up Studies , Graft Survival , Humans , Male , Middle Aged , Wound HealingABSTRACT
Anal incontinence, as a result of traumatic lesions upon the anal sphincter, is a devastating problem. Direct approximation by appropriate repair may not produce the appropriate animation of the anal sphincter and return of function. The transfer of the gracilis muscle for anal sphincteroplasty, which was initially described for neurogenic dysfunction, is recommended for repair and reconstruction of traumatic and dysfunction. The use of this technique in two patients with anal incontinence following trauma proved to be helpful in alleviating the problems of the patients. A diverting colostomy is used prior to the repair of the anal sphincter. Physical therapy regimens of the reconstructed anal sphincter by the muscle transfer is done prior to closing of the colonic stoma and restoring normal continuity and function of the lower part of the alimentary tract.
Subject(s)
Anal Canal/surgery , Muscles/surgery , Anal Canal/injuries , Fecal Incontinence/etiology , Fecal Incontinence/surgery , Humans , MethodsABSTRACT
Once the inadvertent infiltration of Adriamycin occurs, it is recommended to immediately treat the problem. This has been accomplished by wide excision and meshed split thickness skin grafting for resurfacing of the defect. Obtaining a healed wound alleviates the stiffness from lack of motion or ruptured tendons. Pain from the open ulcer, which is prone to infection in the immunosuppressed patient, is lessened. An analogy between pit viper envenomization and Adriamycin infiltration is discussed.
