[The psychiatric health model for meaningful support by family members who must decide on the treatment of life support]. / 'N geestesgesondheidsmodel vir ondersteuning van gesinslede wat moet besluit oor die onttrekking van lewensondersteunende behandeling.

The aim of this research is to develop, describe, operationalize and evaluate a model as framework for meaningful support by the advanced psychiatric nurse, which will serve to support family members who are involved in the decision-making process regarding the withdrawal of life sustaining treatment, in order to promote their mental health. The paradigm of the Department of Nursing of the Rand Afrikaans University, which endorses the Theory for Health Improvement in Nursing (Randse Afrikaanse Universiteit: Departement Verpleegkunde, 200: 1-16) was accepted for the purpose of this research. A theory generating design which is qualitative, descriptive and contextual was used to develop the model as framework of reference for meaningful support. Step one identifies, classifies and defines the central concept "meaningful support", as well as the essential and relative concepts. Step two formulates the inter-relational views of the identified and defined concepts. In step three the guidelines of Chinn & Kramer (1995: 105-124) was utilised for the structural and process description of the model. The structure of the model's process, which comprises three phases, is cyclic. Step four consists of evaluation regarding the process description of the model, done according to the definition of the central concept "meaningful support". The evaluation criteria of Chinn & Kramer (1995: 125-135) were also used.

The promotion of mental health of adolescents in a township in Swaziland.

A number of adolescents have been observed drinking alcohol, pushing and abusing drugs and also stealing cars. A lot of adolescents idle in the township streets, girls are falling pregnant and dropping out of school. No research has been done to elicit the opinions of families on the everyday life of the adolescents in this township. The objectives of this research were twofold, namely. To explore and describe the families' opinions on the everyday life of adolescents in a specific township in Swaziland, and to describe guidelines for advanced psychiatric nurse practitioners to assist these families to mobilize resources in order to promote, maintain and restore mental health as integral part of health of adolescents in this township. A qualitative, exploratory, descriptive and contextual design was used where the research was conducted in two phases. Trustworthiness measures as well as ethical measures were applied throughout the research. Five categories were identified from the result of the focus group interviews with families: Adolescents presenting ineffective communication patterns due to lack of support from their families; adolescents engaging into risky lifestyles related to lack of support and healthy relationship with their parents; families unable to create a supportive and conducive environment for their adolescents due to their focus on own family stumbling blocks and non-availability of recreational centres related to lack of a supportive and conducive environment in the community and inadequate accommodation leading to overcrowding. Guidelines for advanced psychiatric nurse practitioners were deducted from identified themes and the literature control.

Support for nurses directly involved with women who chose to terminate a pregnancy.

Research conducted by Poggenpoel, Myburgh and Gmeiner (1998:2-8) on "One voice regarding the legalization of abortion: Nurses who experience discomfort" indicated that the nurses were in favour of the fact that nurses should volunteer to participate in terminating a pregnancy of a woman. From our observations in clinics where nurses voluntarily participate in providing reproductive health services, including termination of pregnancy, it became clear that supporting these nurses may be essential. To be able to provide support, it is necessary to identify, explore and describe nurses' experience of being directly involved with women who terminate their pregnancy. To enable us to address the identified problems, a qualitative research strategy was implemented in which respondents were included in the sample through purposive sampling. Phenomenological interviews were conducted individually. Data was analyzed by means of Tesch's descriptive approach. Thereafter, guidelines for operationalization were inferred from the results and a literature control completed to verify and enrich guidelines. Measures to ensure trustworthiness have been applied in the research and ethical measures have been strictly adhered to regarding this sensitive issue.

[Effective communication with the mentally challenged person during treatment of minor ailments]. / Fasiliterende kommunikasie met die verstandelik vertraagde persoon tydens die behandeling van geringe ongesteldhede.

The research objectives were to explore and describe the nature of communication with the mentally retarded adult during treatment of minor ailments; and to describe guidelines for the community nurse in order to facilitate more effective communication during the treatment of minor ailments in the mentally retarded adult for the promotion, maintenance and restoration of the mentally retarded individual's health. The community nurse pays attention to the protection of the mentally retarded individual's health, and identifies and treats minor ailments encountered by the mentally retarded individual. Because of the disability of the adults, lacking communication and obstacles in the exchange and interpretation of communication, could take place between the community nurse and the mentally retarded adult. The responsibility lies with the community nurse to facilitate effective communication, since the mentally retarded individual is not always capable of speaking on his/her own behalf. Guidelines are needed for the facilitation of effective communication between the community nurse and the mentally retarded adult during the treatment of minor ailments. In this research, use were made of a qulitative, exploratory, descriptive and contextual design. The research method consisted of participative observation during which video recording and the taking of field notes were applied. Two themes were identified during data analysis, namely: Verbal communication is aimed at the treatment of wounds. The more functional and task-orientated the community nurse's interaction with the mentally retarded individual, the more the mentally retarded individual would generate symptoms to establish emotional contact and interaction; The non-verbal behaviour of the community nurse focuses on the treatment of wounds and organisation of the environment. The more structure is created, the more play-out-behaviour is shown by the mentally retarded individual in need of contact. The researcher came to the conclusion that the community nurse refrains form near/close contact with the mentally retarded individual, to bridge her own discomfort. The community nurse is "busy" with the act of treating wounds, in order to refrain from effective interaction.

One voice regarding the legalisation of abortion. Nurses who experience discomfort.

The legalisation of abortion has been implemented since February, 1997. No research has been conducted on the effects of abortion on nurses. The objectives of this project were: 1. to explore and describe nurses' experience of abortion, and 2. to describe guidelines to support nurses. A qualitative, explorative, descriptive and contextual research design was used. The research was conducted in two phases, i.e., the exploration of nurses' experience, and description of guidelines. Trustworthiness measures as well as ethical measures were applied. Five themes were identified from the result of the interviews with nurses: freedom of choice of nurses to provide support; negative perceptions regarding the women who requested the abortion and staff providing the abortion; need for information; turmoil regarding life versus death, and recommendations from nurses regarding the management of abortion. Guidelines to support nurses were deducted from the identified themes.

[Support for the psychiatric nurse specialist and the psychiatric community nurse in their interactions with the psychiatric patient. Part II]. / Ondersteuningsbenadering aan psigiatriese gemeenskapsverpleegkundiges in interaksie met psigiatriese pasiënte. Deel II.

In this article the research is described that had as goal to generate a supportive approach for the psychiatric nurse specialist to the psychiatric community nurse in interaction with the psychiatric patient, to promote, maintain and restore their mental health as an integral part of health. Guidelines for operationalisation of this supportive approach by the psychiatric nurse specialist, are also described. The research design utilised a qualitative, descriptive and contextual design. The exploratory field work was done in phase one of this research (as described in part I of these articles) and consisted of phenomenological interviews and focus groups. Trustworthiness was ensured by utilising Guba's model for trustworthiness.