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    Teaching basic relaxation procedures to psychiatric patients receiving electronconvulsive therapy : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1982) Simons, Bruce Francis
    There has been no research on psychiatric patients examining the ability to remember relaxation skills whilst receiving electroconvulsive therapy. This thesis addressed itself to the question of whether the patients could remember the relaxation procedures that were taught immediately before, during, or immediately after the ECT series. Fourteen patients were assigned to three different groups. The first group received the relaxation training (RT) prior to beginning the ECT series, the second group received the RT during the ECT series and the third group received the RT immediately after the ECT series. Assessment was made of the verbal instructions taught to the patients using a checklist devised by the author. Comparisons were made between patients on their performance according to several different independent variables, diagnosis, frequency of ECT, response to treatment and order of presentation effects. Eleven of the fourteen subjects learnt the RT procedures within three training sessions. The remaining subjects failed to learn the RT procedures in six sessions but this study did not confirm that ECT was a precipitant in their failure to learn. No significant effect was associated with diagnosis, frequency of ECT or response to treatment. It was concluded that it is possible to teach RT procedures to the majority of psychiatric patients at the institution where this study was completed. This study produced no evidence to suggest that it is preferable to teach RT to patients at any particular point in ECT treatment sequence and in addition there was no evidence of any anterograde or retrograde amnesic effects associated with ECT sufficient to interfere with the learning of verbal instructions associated with RT.
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    Patients' treatment requests, psychiatrists' understanding of patient requests, and adherence to treatment : a thesis presented ... for the degree of Master of Science in Clinical Psychology at Massey University
    (Massey University, 1982) Deane, Frank Patrick
    This study aimed to determine the treatment requests of patients in the initial psychiatric interview and to compare the relative preference or these requests to those of other patient samples. It also aimed to determine psychiatrists accuracy in estimating the importance their patients placed on their requests, and to explore the relationship between psychiatrist understanding of patient requests to patient adherence to treatment. The study was carried out on 269 consecutive new patients to a psychiatric unit attached to a public hospital of whom 85 completed a 14 item Patient Request Form before their initial interview, and their psychiatrists completed an equivalent form at the conclusion of the interview. Patients adhered if they returned for their next appointment. Generally it was found that patients wanted psychologically based treatments most and medical oriented treatment least, and that the rank orders of the requests provided significant positive correlations with all other samples. It was found that psychiatrists significantly underestimated six request categories and overestimated one, supporting nine of the 14 differences hypothesised. No significant relationship was found between adherence and psychiatrists understanding of patients requests. Results are discussed in terms of their implications for helping therapists understand their patients requests.
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    A thematic analysis of factors influencing decisions to use physical restraint in acute mental health settings : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing, Massey University
    (Massey University, 2007) Edgar, Murray James
    This study investigates the factors that influence nurses' decisions to use physical restraint or to attempt alternative interventions within acute mental health inpatient settings. The objective was to better understand the background to these decisions in the hope that this will lead to the development of more consistent and justifiable approaches to challenging behaviour displayed by some mental health patients. Eight nurses working or recently working in acute mental health services in two different District Health Boards were interviewed using a semi-structured interview technique. The sample was purposive, with participants being asked about their experiences with physical restraint, using specific events from their clinical practice. These interviews were then reviewed by the researcher and note taken of areas for further exploration or clarification. A second interview focussed on the areas identified as of particular interest to this research. 32 events of restraint use or near-use were related to the researcher, giving a significant amount of data for analysis. A thematic analysis approach was used to identify and examine themes within the data. The central thesis emerging from the data and its analysis is that much of what influences nurses' decisions relates to intrinsic factors such as their attitudes towards the patients in their care, whether the patients are appropriately domiciled in mental health services, and assessments of the causes of the challenging behaviour. The importance of working as a team and trusting colleagues emerged as a strong yet previously under-researched theme. Implications for nursing practice are discussed. Particular emphasis is placed on the further development of Calming and Restraint programmes for nurses working in acute mental health settings. The need to address the background attitudinal factors from both a training and service delivery perspective is strongly evident.
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    The implementation of trauma informed care in acute mental health inpatient units : a comparative study : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2013) Ashmore, Toni Rae
    Trauma informed care (TIC); particularly related to interpersonal violence, is a burgeoning topic for mental health services in both New Zealand and Australia. This thesis compares the implementation of trauma informed care, particularly in relation to interpersonal violence, in an acute mental health inpatient unit in New Zealand and a similar unit in New South Wales, Australia. A policy analysis was undertaken of current policy documents that guide each unit, along with semistructured interviews with ten senior staff, five from each unit to investigate implementation of key features of trauma informed care, particularly in relation to interpersonal violence. Results showed a difference in overall implementation between the two units. Single interventions rather than a whole of service change of philosophy were evident. Differences were identified in relation to policies referring to interpersonal violence, staff knowledge and understanding of trauma informed care, access to training and resources, how safety was provided for, collaborative care arrangements and workplace power dynamics for both clients and staff. Across both units were identified a lack of guidance to inform implementation of TIC, consumer involvement and practice around diversity. Contributing factors for TIC implementation include having a clear definition of TIC, commitment at all governance levels, access to TIC training for all staff, and policies underpinned by TIC. Further research investigating these results may enhance service delivery, resulting in better outcomes for the promotion of recovery and healing of those with histories of interpersonal violence.