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Social work services to families caring for adult relatives with a mental illness
Full text linkThesis (DPhil)--Stellenbosch University, 2023.ENGLISH ABSTRACT: When families take care of a relative with a mental illness, it can cause tremendous stress to the family and the patient. Rendering social work services to such families would relieve stress and contribute to everyone’s quality of life. Globally, about one in four families has a relative with a mental illness, and with limited access to and limited resources, families must often look after and care for such relatives. Families must thus contend with multiple sources of stress, including stress relating to their relative's mental illness, symptoms and behaviours, and societal stigmatisation. If support services to families caring for adult relatives with a mental illness are limited or unavailable, families and their relatives with mental illness, suffer. Unfortunately, this is the situation in South Africa where the National Mental Health Policy Framework and Strategic Plan (Department of Health, 2012) and the Mental Health Care Act 17 of 2002, are in support of deinstitutionalising mental health patients. This means that patients should be discharged from mental institutions as soon as reasonably possible to be treated in their communities. Nationally, however, South Africa’s existing mental health frameworks are confronted by numerous challenges, such as the exchange of care of patients from institutions to community-based care, political contemplations in developing policy, stigmatisation of people with mental health issues, and a lack of community-based services. These challenges all directly impact families taking care of a relative with mental illness. Due to an unrelenting increase in people experiencing mental illnesses and the number of families reporting such problems, the demand for and necessity of rendering social work services to families taking care of an adult relative with a mental illness have been emphasised. Apart from the increasing demand for rendering direct social work services to families who take care of people with mental illness, there is also a lack of, or poor and rarely available community-based social work services to families of mentally ill relatives. Amid the drive for deinstitutionalisation and the subsequent focus on community-based mental health services in South Africa, there is insufficient empirical research regarding social work services rendered to families caring for a relative with a mental illness. Existing research does not specify social work services to families caring for a relative with a mental illness but focus mostly on interventions for the mentally ill individual.AFRIKAANSE OPSOMMING: As gesinne vir 'n familielid met 'n geestesongesteldheid moet sorg, kan dit tot geweldige stres vir die gesin en die pasiënt lei. Die lewering van maatskaplike dienste aan sodanige gesinne sal stres verlig en tot almal se lewenskwaliteit bydra. Wêreldwyd het ongeveer een uit elke vier gesinne 'n familielid met 'n geestesongesteldheid en met beperkte toegang tot en beperkte hulpbronne, moet gesinne dikwels self vir hierdie familielede sorg. Gesinne moet dus veelvuldige bronne van stres hanteer, insluitend stres wat verband hou met hul familielid se geestesongesteldheid, simptome, gedrag, en stigmatisering deur die gemeenskap. As ondersteuningsdienste aan gesinne wat na volwasse familielede met 'n geestesongesteldheid omsien, beperk is, of nie beskikbaar is nie, ly gesinne en hul geestesongestelde familielede daaronder. Ongelukkig is dit tans die situasie in Suid-Afrika waar die Nasionale Geestesgesondheidsbeleidsraamwerk en Strategiese Plan en die Geestesgesondheidsorgwet 17 van 2002, die deïnstitusionalisering van geestesongestelde pasiënte ondersteun. Met ander woorde, pasiënte moet so gou as redelik moontlik vanuit hospitale ontslaan en in hul gemeenskappe behandel word.
Landwyd word Suid-Afrika se bestaande geestesgesondheidsraamwerke egter met talle uitdagings gekonfronteer, soos die afwenteling van die sorg van geestesongestelde pasiënte van instellings na gemeenskapsgebaseerde sorg, politieke oorwegings wat in ag geneem moet word in die ontwikkeling van beleide, die stigmatisering van mense met geestesgesondheids-kwessies, en die algemene gebrek aan gemeenskapsgebaseerde dienste. Hierdie uitdagings het 'n direkte impak op gesinne wat 'n familielid met geestesongesteldheid versorg.
Weens 'n geweldige toename van mense wat geestesiektes ervaar en die aantal gesinne wat sodanige probleme aanmeld, word die vraag na, en noodsaaklikheid van die lewering van maatskaplikewerk dienste aan gesinne wat na 'n volwasse familielid met 'n geestesongesteldheid omsien, beklemtoon. Afgesien van die toenemende vraag na die lewering van direkte maatskaplikewerk dienste aan gesinne wat na familielede met geestesongesteldheid omsien, is daar in elkgeval 'n gebrek aan gemeenskapsgebaseerde maatskaplikewerk dienste vir gesinne van geestesongestelde familielede. Te midde van die strewe na deïnstitusionalisering en die gevolglike fokus op gemeenskapsgebaseerde geestesgesondheidsdienste in Suid-Afrika, is daar min empiriese navorsing oor maatskaplikewerk dienste wat aan gesinne wat na 'n familielid met 'n geestesongesteldheid omsien, gelewer word.Doctora
Experiences of family members caring for female patients with a co-morbid diagnosis of bipolar and substance abuse admitted in a psychiatric hospital in the Western Cape
No full textMagister Artium (Social Work) - MA(SW)Caregivers of people with psychiatric illnesses experience challenges, which contribute significantly to their burden of care and can result in health and mental health problems. The researcher was interested in the lived experiences of caregivers, which resulted in the following research questions: What are the lived experiences of caregivers caring for a co-morbid bi-polar and substance-abuse patient, and what context and situations contribute to the problems? The goal of this research was to explore the experiences of family members caring for relatives admitted in a psychiatric hospital, and the contexts in which these occurred. The objectives were to explore and describe the lived experiences of family members caring for a relative with a co-morbid diagnosis of bi-polar and substance abuse, as well as the situations or contexts in which these experiences occur. These objectives were followed by the last objective of the research, which was to make recommendations to the multi-disciplinary teams (MDTs) on services for family members caring for such a relative. A qualitative, phenomenological research approach was used for this study with explorative and descriptive research designs. The population for the study comprised families in the Western Cape caring for female relatives admitted to a psychiatric hospital with co-morbid bipolar and substance use disorder. The researcher purposively selected relatives of female in-patients admitted in a female admission ward. Families were chosen whose members were admitted for more than three months. In-depth phenomenological interviews were done with six participants until data saturation was reached. Phenomenological data analysis, focusing on the textural (lived experience) and structural (context in which it was experienced), were followed after data collection. Findings comprised a composite description of the phenomena of both textural and structural description. The findings of this research resulted in conclusions and recommendations for MDTs and social work on interventions for family members caring for a family member with this mental condition.
Findings from this study conclude what was found in the literature regarding challenges in the system leads to caregivers feeling burdened with their mentally ill relative, and that resources and support are lacking in communities. This led to recommendations aiming at MDTs, government and social workers working in institutions, to align with community social workers in order to strengthen working relationships with the aim of providing the necessary support services to families caring for mentally ill relatives. Future research suggestions are also aimed at supporting families caring for patients with a mental illness for which reasons for re-admissions will be assessed and evaluated
Experiences of family members caring for female patients with a co-morbid diagnosis of bipolar and substance abuse admitted in a psychiatric hospital in the Western Cape
Full text linkMagister Artium (Social Work) - MA(SW)Caregivers of people with psychiatric illnesses experience challenges, which contribute significantly to their burden of care and can result in health and mental health problems. The researcher was interested in the lived experiences of caregivers, which resulted in the following research questions: What are the lived experiences of caregivers caring for a co-morbid bi-polar and substance-abuse patient, and what context and situations contribute to the problems? The goal of this research was to explore the experiences of family members caring for relatives admitted in a psychiatric hospital, and the contexts in which these occurred. The objectives were to explore and describe the lived experiences of family members caring for a relative with a co-morbid diagnosis of bi-polar and substance abuse, as well as the situations or contexts in which these experiences occur. These objectives were followed by the last objective of the research, which was to make recommendations to the multi-disciplinary teams (MDTs) on services for family members caring for such a relative. A qualitative, phenomenological research approach was used for this study with explorative and descriptive research designs. The population for the study comprised families in the Western Cape caring for female relatives admitted to a psychiatric hospital with co-morbid bipolar and substance use disorder. The researcher purposively selected relatives of female in-patients admitted in a female admission ward. Families were chosen whose members were admitted for more than three months. In-depth phenomenological interviews were done with six participants until data saturation was reached. Phenomenological data analysis, focusing on the textural (lived experience) and structural (context in which it was experienced), were followed after data collection. Findings comprised a composite description of the phenomena of both textural and structural description. The findings of this research resulted in conclusions and recommendations for MDTs and social work on interventions for family members caring for a family member with this mental condition.
Findings from this study conclude what was found in the literature regarding challenges in the system leads to caregivers feeling burdened with their mentally ill relative, and that resources and support are lacking in communities. This led to recommendations aiming at MDTs, government and social workers working in institutions, to align with community social workers in order to strengthen working relationships with the aim of providing the necessary support services to families caring for mentally ill relatives. Future research suggestions are also aimed at supporting families caring for patients with a mental illness for which reasons for re-admissions will be assessed and evaluated
Experiences of family members caring for female patients with a co-morbid diagnosis of bipolar and substance abuse admitted in a psychiatric hospital in the Western Cape
No full textMagister Artium (Social Work) - MA(SW)Caregivers of people with psychiatric illnesses experience challenges, which contribute significantly to their burden of care and can result in health and mental health problems. The researcher was interested in the lived experiences of caregivers, which resulted in the following research questions: What are the lived experiences of caregivers caring for a co-morbid bi-polar and substance-abuse patient, and what context and situations contribute to the problems? The goal of this research was to explore the experiences of family members caring for relatives admitted in a psychiatric hospital, and the contexts in which these occurred. The objectives were to explore and describe the lived experiences of family members caring for a relative with a co-morbid diagnosis of bi-polar and substance abuse, as well as the situations or contexts in which these experiences occur. These objectives were followed by the last objective of the research, which was to make recommendations to the multi-disciplinary teams (MDTs) on services for family members caring for such a relative. A qualitative, phenomenological research approach was used for this study with explorative and descriptive research designs. The population for the study comprised families in the Western Cape caring for female relatives admitted to a psychiatric hospital with co-morbid bipolar and substance use disorder. The researcher purposively selected relatives of female in-patients admitted in a female admission ward. Families were chosen whose members were admitted for more than three months. In-depth phenomenological interviews were done with six participants until data saturation was reached. Phenomenological data analysis, focusing on the textural (lived experience) and structural (context in which it was experienced), were followed after data collection. Findings comprised a composite description of the phenomena of both textural and structural description. The findings of this research resulted in conclusions and recommendations for MDTs and social work on interventions for family members caring for a family member with this mental condition.
Findings from this study conclude what was found in the literature regarding challenges in the system leads to caregivers feeling burdened with their mentally ill relative, and that resources and support are lacking in communities. This led to recommendations aiming at MDTs, government and social workers working in institutions, to align with community social workers in order to strengthen working relationships with the aim of providing the necessary support services to families caring for mentally ill relatives. Future research suggestions are also aimed at supporting families caring for patients with a mental illness for which reasons for re-admissions will be assessed and evaluated
YOUTHS IN GANGS ON THE CAPE FLATS, SOUTH AFRICA: PARENTS TALK BUT WHO LISTENS?
Full text linkThe appeal of gang membership to young people is an ongoing concern, especially for social workers serving affected communities. This article is part of a larger research study (2016-2018) by social work students. These are the findings of the 2017 study on the perceptions of parents or caregivers about the allure of gang membership to young people. A qualitative approach, utilising an exploratory research design, was employed. The necessary ethics approval from the institution was obtained for data collection. Individual interviews were conducted with 325 parents on the Cape Flats in the Western Cape. Six themes emerged from a thematic data analysis, such as socio-political causes and effects, the role of parents and family, as well as interventions and role players. Key findings show that parents do reflect on what happens in communities, but their opinions do not always count for interventions and policies. Policy and justice issues require considerable thought as they frame the world in which people live and are intended to ensure that the voices of those most affected are heard. Community participation and professional intervention should be a reflection of the role of marginalisation and powerlessness
THE IMPLEMENTATION OF MENTAL HEALTH POLICY AND LEGISLATION: IS DEINSTITUTIONALISATION A PREDICAMENT FOR SOCIAL WORKERS AND FAMILIES?
Full text linkGlobally, policy and legislation on mental health have shifted towards deinstitutionalisation. South African policy and legislation were adapted to adhere to international policy directives, resulting in a strong emphasis on reintegrating people with mental illness into their families and communities. The practical implementation of this shift depends on the existence of community-based organisations to support families and persons with mental illness. However, no research is available on the view of social workers on the implementation of mental health policy and legislation and the possible challenges experienced with deinstitutionalisation. To investigate if deinstitutionalisation presented a predicament for social workers and families, a qualitative approach – with exploratory and descriptive research designs – was employed with social workers and their supervisors working at selected psychiatric hospitals. These participants were approached specifically because they are often at the frontline of implementing mental health policy and legislation. It was concluded that existing legislation was superficial, unknown and patient-driven, and that deinstitutionalisation was viewed as an ineffective reintegration strategy. Recommendations are that policymakers must reassess the implications of this legislation and address community-based resources to support the proper deinstitutionalisation of and care for people with mental illness and their families
Family members’ experiences: People with comorbid bipolar and substance use disorder
No full textPeople with comorbid bipolar and substance use disorders are complex, whose families experienced challenges contributing significantly to their burden of care. The aim of the study was to explore these lived experiences of family members caring for relatives, as well as the situations or contexts in which they experience these. A qualitative phenomenological research approach with explorative, descriptive research designs was adopted. In-depth phenomenological interviews were done with six purposive selected participants. Phenomenological data analyses focusing on the textural (lived experience) and structural (the context in which it was experienced) were followed after data collection. The lived experiences of participants included feelings of helplessness and emotional and physical exhaustion, as well as the causes of these feelings. The situations contributing to these feelings included non-compliance with prescribed medicine for bipolar disorder combined with drug abuse as well as a threat to the safety of the patient and others, stigmatisation, embarrassment and shame
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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