PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ

Transkript

1 II. Uluslararası VI. Ulusal PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. International VI. National PSYCHIATRIC NURSING CONGRESS Herkes için Ruh Sağlığı / Mental Health for Everyone 4-7 Ekim 2012 Atatürk Üniversitesi Kültür ve Gösteri Merkezi ERZURUM Atatürk University Cultural Center October 4-7, 2012 ERZURUM/TURKEY ÖZET KİTABI/ABSTRACT BOOK

2 *Yazılar ile ilgili tüm bilimsel ve etik sorumluluk yazarlara aittir Scientific and ethical responsibilities pertaning to the papers belong to the authors

3 İçindekiler Giriş / Introduction 5 Düzenleme Kurulu / Organizing Committee 6 Bilimsel Danışma Kurulu / Scientific Committee 7 Bilimsel Program / Scientific Program 8 Konuşmacı Metinleri / Speaker Text 16 Kurslar / Courses 90 Çalıştay / Workshop 100 Sözel Bildiriler / Oral Presentations 104 Posterler / Poster Presentations 160 Yazar İndeksi / Author Index 465

4 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS 4

5 Giriş / Introduction Değerli Meslektaşlarımız, Psikiyatri Hemşireleri Derneği ve Atatürk Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü Psikiyatri Hemşireliği Anabilim Dalı olarak 4-7 Ekim 2012 tarihlerinde gerçekleştireceğimiz 2. Uluslararası 6. Ulusal Psikiyatri Hemşireliği Kongresi nde sizleri aramızda görmekten büyük mutluluk duyacağız. 2. Uluslararası 6. Ulusal Psikiyatri Hemşireliği Kongresi nin 2012 yılı teması Herkes için Ruh Sağlığı olarak belirlenmiştir Dünya Ruh Sağlığı Günü kampanyası En İyi Yatırım Ruh Sağlığına Yatırımdır cümlesiyle açılmıştı. Bu tema ruh sağlığı alanına yatırım yapılmadığı takdirde, ruhsal sorunları olan bireylerden oluşan bir toplumda diğer yatırımların verimli olmayacağı hatta bir anlamı olamayacağını vurgulamaktadır. Ruh sağlığı hizmetlerinin geliştirilip iyileştirilmesi konusunda yapılacak her türlü girişim oldukça önemlidir. Ruhsal hastalıklar seçici davranmaz; her bireyde, her kültürde ve yaşamın her evresinde olabilir. Dünyada ve Ülkemizde ruh sağlığının geliştirilmesi ve iyileştirilmesine yönelik konuları çeşitli konferans ve paneller ile irdeleyeceğimiz kongremizde, her yıl olduğu gibi kurs ve çalışma gruplarımız da yer alacaktır. Kongrenin konferans ve panel oturumlarının, çalışma gruplarının, sözel ve poster bildirilerinin sizlerin katkıları ile zenginleşeceğine inanıyoruz. Ekim ayı başında katılımınızla zenginleşecek güzel bir kongrede buluşmak üzere sizleri eşsiz tarihi ve doğa güzellikleri ile büyüleyecek olan Erzurum a davet ediyoruz. Dear Colleagues, We would be pleased to see you amongst us at the 2nd International 6th National Psychiatric Nursing Congress by the Psychiatric Nursing Association and Atatürk University, Health Sciences Faculty, Nursing Program, Psychiatric Nursing Department will be organized on 4-7 October The theme for the 2nd International 6th National Psychiatric Nursing Congress has been determined to be Mental Health for Everyone. The opening sentence of the campaign for the 2011 World Mental Health Day was Mental Health is the Best Investment. This theme emphasizes that unless investment is made to mental health in a society consisting of people with mental health problems, no other investment will be efficient, even meaningful. Any initiative intended at the development and improvement of the mental healthcare services is of significant importance. Mental disorders are not choosy; they can come up in any individual, culture and at every stage of life. Our congress, where we are going to examine topics related to the development and improvement of mental health in our country and the world at various conferences and panels will also include courses and workshops like every year. We believe that the conferences, panels, workshops, oral and poster statements at our congress will be enriched with your contributions. We invite you to Erzurum, which will fascinate you with its unique history and natural beauties, to meet at a productive congress which will be enriched with your participation and contributions at the beginning of October. Doç. Dr. Ayşe Okanlı Kongre Eş Başkanı President of the Congress Doç. Dr. Yasemin Kutlu Kongre Eş Başkanı President of the Congress 5

6 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS DÜZENLEME KURULU / ORGANIZING COMMITTEE ONURSAL BAŞKANLAR / HONORARY PRESIDENTS Prof. Dr. Hikmet Koçak Atatürk Üniversitesi Rektörü / The Rector of Atatürk University Prof. Dr. Türkan Pasinlioğlu A.Ü. Sağlık Bilimleri Fakültesi Dekanı / The Dean of Atatürk University, Health Science Faculty Prof. Dr. İsmet Kırpınar Bezmiâlem Vakıf Üniversitesi Psikiyatri AD Başkanı / The President of Bezmialem Foundation University, Psychiatry Department Prof. Dr. Çaylan Pektekin Psikiyatri Hemşireleri Derneği Kurucu Başkanı / The First President of Turkish Psychiatric Nurses Association Önceki PHD Başkanları / The Previous Presidents of Turkish Psychiatric Nurses Association Prof. Dr. Nesri Aştı Prof. Dr. Sevim Buzlu Dr. Nurhan Eren KONGRE BAŞKANLARI / THE PRESIDENTS OF CONGRESS Yasemin Kutlu Ayşe Okanlı KONGRE SEKRETERLERİ / THE GENERAL SECRETARY Sibel Asi Karakaş Neslihan Keser Özcan SAYMANLAR / TREASURES Arzu Aydoğdu Hatice Durmaz ÜYELER / MEMBERS Hacer Atik Tosunlar Nazan Aydın Hülya Bilgin Erdem Deveci Mine Ekinci Kübra Güngörmüş Semra Karaca Hatice Kırtaş Aşık Zeynep Koç Nevin Onan Erol Ozan Meryem Sifil Özlem Şahin Altun Emine Toğ 6

7 BİLİMSEL DANIŞMA KURULU / SCIENTIFIC COMMITTEE Ebru Akgün Çıtak /Turkey Arzu Altunay / Turkey Gülsüm Ançel / Turkey Hülya Arslantaş / Turkey Nesrin Aştı / Turkey Aysun Babacan Gümüş / Turkey Elçin Babaoğlu Akdeniz / Turkey Makbule Batmaz / Turkey Leyla Baysan Arabacı/Turkey Ayşegül Bilge / Turkey Hülya Bilgin / Turkey Nihal Bostancı Daştan / Turkey Kadriye Buldukoğlu / Turkey Sevim Buzlu / Turkey Len Bowers / İngiltere Sibel Coşkun / Turkey John Cutcliffe / USA, UK Olcay Çam / Turkey Zekiye Ç. Duman / Turkey Meral Demiralp / Turkey Fatma Demirkıran / Turkey Satı Dil / Turkey Aynur Dinç Sever / Turkey Selma Doğan / Turkey Gülgün Durat / Turkey Şeyda Dülgerler / Turkey Fatma Eker / Turkey Mine Ekinci / Turkey Esra Engin / Turkey Nurhan Eren / Turkey Nalan Gördeles Beser / Turkey Perihan Güner Küçükkaya / Turkey Neslihan Günüşen/Turkey Ayça Gürkan / Turkey Özlem Işıl / Turkey Figen İnci / Turkey Songül Kamışlı / Turkey Semra Karaca / Turkey Meral Kelleci / Turkey Gülseren Keskin/Turkey Nazmiye Kocaman Yıldırım / Turkey Nebahat Kum / Turkey Leman Kutlu / Turkey Yasemin Kutlu / Turkey Leyla Küçük / Turkey Fahriye Oflaz / Turkey Ayşe Okanlı / Turkey Nevin Onan / Turkey Şeyda Öktem / Turkey Fatma Öz / Turkey Gülten Özaltın / Turkey Derya Özbaş / Turkey Ayşe Özcan / Turkey Neslihan Özcan / Turkey Mine Özen Turgay / Turkey Gönül Özgür / Turkey Çaylan Pektekin / Turkey Peter Philips / U.K. Roland van de Sande / Netherlands Serap Sezgin / Turkey Derya Tanrıverdi / Turkey Hatice Tambağ / Turkey Gülay Taşdemir / Turkey Havva Tel / Turkey Gülşen Terakye / Turkey Serpil Türkleş / Turkey Nezihe Uğurlu / Turkey Gül Ünsal / Turkey Besti Üstün / Turkey Arzu Yıldırım / Turkey Serap Yıldırım / Turkey Mualla Yılmaz / Turkey 7

8 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 1. Gün / 4 Ekim 2012 / 1 st Day-October 4, 2012 A SALONU / A HALL Çalıştay / Consensus : Ruh Sağlığı-Psikiyatri Hemşireliğinin Eğitimi Education of Mental Health and Psychiatric Nursing Moderatörler / Moderators : Kadriye Buldukoğlu & Selma Doğan B SALONU / B HALL Çalıştay / Consensus : Ruh Sağlığı-Psikiyatri Hemşireliğinin Uygulaması Practice of Mental Health and Psychiatric Nursing Moderatörler / Moderators : Nurhan Eren & Münevver Akın & Hacer Atik Çalışma Grupları / Workshops C,D,E,F,G SALONLARI / C,D,E,F,G HALLS 8

9 BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 2. Gün / 5 Ekim 2012 / 2 nd Day-October 5, Kayıt / Registration Müzik Dinletisi / Music Concert A SALONU / A HALL Açılış Töreni / Opening Ceremony Doç. Dr. Ayşe Okanlı Doç. Dr. Yasemin Kutlu Roland van de Sande Prof. Dr. Türkan Pasinlioğlu Prof. Dr. Hikmet Koçak Doç. Dr. Serhat Vançelik Sebahattin Öztürk Kahve Arası / Coffee Break Konferans / Conference : Modern başarı-yönelimli toplumların çalışanları, hastaları ve üyelerinin bozukluğa özgü davranışlarının önlenmesi için katılımcı ve bütünleştirici önlemler Participative and integrative measures fort he prevention of disorder-specific behavior of staff, patients and members of the modern achievement-oriented society Moderatör / Moderator : Çaylan Pektekin Konuşmacı / Speaker : Iris Mayenburg Altwarg Konferans / Conference : Tespit yöntemleri klinikler ve ülkeler arasında niçin farklıdır, şimdiye kadar bildiklerimizin bir özeti Why rates of restraint and other containment methods differ between wards and countries, a summary of what we know so far Moderatör / Moderator : İsmet Kırpınar Konuşmacı / Speaker : Len Bowers Öğle Yemeği & Uydu Sempozyumu Lunch & Satellite Symposium Tedavi İşbirliği Programı Treatment Corporation Program Konuşmacı / Speaker : Prof. Dr. Ayşen Esen Danacı Poster Başı Tartışması / Poster Discussion Konferans: Akıl hastalarında madde kullanımını anlamak: Psikotik yatan hastalardan oluşan bir grupta uyuşturucu ve alkol kullanımının bağlam ve motivasyonları üzerine bir araştırma Understanding substance use amongst the mentally ill: an investigation of the context of, and motivations for, drug and alcohol use among an in-patient sample of individuals with psychotic illness Moderatör / Moderator : Gülşen Terakye Konuşmacı / Speaker : Peter Philips Kahve Arası / Coffee Break Konferans / Conference : Psikiyatride işlevsellik ve bozulması Functionality in psychiatry and impairment Moderatör / Moderator : Sevim Buzlu Konuşmacı / Speaker : İsmet Kırpınar Konferans / Conference : Baskı ve şiddeti azaltmak için umut verici taktiklere psikiyatri hemşirelerinin katılımı The Contribution of Psychiatric Nurses in Promising Strategies to Minimize Coercion and Violence Moderatör / Moderator : Ayşe Özcan Konuşmacı / Speaker : Roland van de Sande 9

10 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 2. Gün / 5 Ekim 2012 / 2 nd Day-October 5, 2012 B SALONU / B HALL Konferans / Conference : Akılcı İlaç Kullanımı Panel / Panel : Aile ve Psikiyatrik Bozukluklar Family and psychiatric disorders Moderatörler / Moderators : Havva Tel & Nazmiye Kocaman Yıldırım Konuşmacılar / Speakers : Ruhsal hastalıklar ve aile: Güçlükler, duygular, gereksinimler / Psychiatric disorders and family: Difficulties, feelings, needs Sevgi Nehir Türkmen Anksiyete bozuklukları ve aile / Anxiety disorders and family Murat Demet Panel / Panel : Dokunsan kırılan dokunmasan kuruyanların dönemi:yaşlılık Period of drying not touches, touches the broken: Old Age Moderatörler / Moderators : Mehtap Tan & Nazlı Hacıalioğlu Konuşmacılar / Speakers : Yaşlılık dönemi psikolojik özellikler ve moral / Morale and psychological characteristics of old age Sibel Asi Karakaş Yaşlılık ve Depresyon / Depression and old age Elif Oral Yaşlılık ve uyku sorunları / Sleep problems and old age Mustafa Güleç Yaşlı istismarı ve ihmali / Neglect and elderly abuse Özlem Şahin Altun C SALONU / C HALL Sözel Bildiriler / Oral Presentations Moderatörler / Moderators : Mağfiret Kaşıkçı & Özlem Işıl D,E,F,G SALONLARI / D,E,F,G HALLS Çalışma Grupları / Workshops Açılış Kokteyli / Opening Coctail 10

11 BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 3. Gün / 6 Ekim 2012 / 3 rd Day-October 6, Müzik Dinletisi / Music Concert A SALONU / A HALL Panel / Panel : Ruh sağlığı hizmetlerindeki gelişmelerin psikiyatri hemşireliğine yansımaları The reflections of the improvements in psychiatric and mental health services Moderatörler / Moderators : Nesrin Aştı & Yasemin Kutlu Konuşmacılar / Speakers : Hizmet kullanıcılarının ve çalışanların gözüyle toplum ruh sağlığı hizmetleri / The services of Community Mental Health Centers: the perspective of the service users and providers Gülsüm Ançel Toplum ruh sağlığı hizmetlerinde ruh sağlığı hemşireleri: roller, eğitimleri ve yeterlilikleri / Psychiatric and mental health nurses in the field of community mental health services: Roles, education and competencies Fahriye Oflaz Toplum ruh sağlığı merkezlerinin çalışma sistemi / The System of Community Mental Health Centers Sevim Öztürk Kahve Arası / Coffee Break Panel / Panel : Akut psikiyatri kliniklerindeki hemşirelik uygulamalarında gelişmeler Developments in nursing practice in acute psychiatric clinics Moderatör / Moderator : Selma Doğan Konuşmacılar / Speakers : Akut psikiyatri kliniklerinde hasta bakım uygulamalarının durumu ve gelişmeler / Practicies of patient care in acute psychiatric wards and developments Selma Doğan Akut psikiyatrik bakımda hemşirelik gözlemleri / Observations of nursing in acute psychiatric care Selma Sabancıoğulları Akut psikiyatrik bakımda kanıta dayalı uygulamalar Evidence-based practices in acute psychiatric care Meral Kelleci Akut psikiyatri kliniklerinde hasta güvenliği uygulamaları / Patient safety practices in acute psychiatric care Leyla Daştan Öğle Yemeği / Lunch Poster Başı Tartışması / Poster Discussion Panel / Panel : Ölümü karşılama, ölüyü yolculama Welcome death, see off dead Moderatör / Moderator : Olcay Çam Konuşmacılar / Speakers : Ölüm Sürecinde Hasta Olmak / Being Patient in the Process of Death Olcay Çam Hasta Yakını Olmak / Being relatives in the Process of Death Ayşegül Bilge Sağlık Çalışanı Olmak / Being health worker in the Process of Death Gülseren Keskin Kahve Arası / Coffee Break Panel / Panel : Klinik psikiyatri hemşireliğinde psikososyal bakım uygulamaları Psychosocial care practices in clinical psychiatric nursing Moderatör / Moderator : Fatma Öz Konuşmacılar / Speakers : Bilişsel davranışçı uygulamalar / Cognitive-behavioral practices Dilek Avcı Sanatın rehabilitasyon amaçlı kullanımı / The use of art in rehabilitation Nurhan Eren Psikoeğitimsel uygulamalar / Psychoeducational practices Gül Ünsal Motivasyonel görüşme / Motivational interviewing Hilal Seki Öz 11

12 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 3. Gün / 6 Ekim 2012 / 3 rd Day-October 6, 2012 B SALONU / B HALL Panel / Panel : Anlaşmazlıklarımızı çözebiliriz We can solve disagreements Moderatörler / Moderators : Ayşe Okanlı & Nezihe Uğurlu Konuşmacılar / Speakers : Yaşantımızın doğal bir parçası olan çatışmalar / Conflict with a natural part of our lives Özlem Şahin Altun Çatışmaların çözümünde etkili olan atılganlık becerileri / Assertiveness skills that are effective in solving conflicts Sibel Asi Karakaş Çözümlenemediğinde meydana gelen kriz / Crisis that occurs when cannot be resolved Semra Karaca Kahve Arası / Coffee Break Panel / Panel : Psikiyatri kliniklerinde üç maymunu oynamak Play three monkeys in psychiatric clinics Moderatör / Moderator : Yasemin Kutlu Konuşmacılar / Speakers : Duyulmayan: Sigara / Unheard: Cigarette Hülya Bilgin Konuşulmayan: Üreme sağlığı / Unspoken: Sexuality and reproductive Neslihan Keser Özcan Görülmeyen: Beslenme / Invizible: Nutrition Leyla Küçük Öğle Yemeği / Lunch Panel / Panel : Yaşamın Özel Dönemlerinde Kadın ve Ruh Sağlığı Woman and Mental Health special periods of life Moderatörler / Moderators : Türkan Pasinlioğlu & Mine Ekinci Konuşmacılar / Speakers : Gebelik döneminde kadın / Women during pregnancy Serap Apay Annelik döneminde kadın / Women during maternity Havva Özkan Menapoz döneminde kadın / Women during menopause Atakan Al Kahve Arası / Coffee Break Panel / Panel : Anne karnından ergenliğe çocuk ruh sağlığı Mental health of children from mother s womb to adolescence Moderatörler / Moderators : Ayda Çelebioğlu&Duygu Arıkan Konuşmacılar / Speakers : Anne karnından bebeklik dönemine ruh sağlığı / Mental health from mother s womb to newborn Sibel Küçükoğlu Okul öncesi ve okul döneminde ruh sağlığı / Mental health the period of pre-school and school Aynur Aytekin Ergenlik döneminde ruh sağlığı / Mental health in adolescence Fatma Güdücü Tüfekçi 12

13 BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 3. Gün / 6 Ekim 2012 / 3 rd Day-October 6, Sözel Bildiriler / Oral Presentations Moderatörler / Moderators : Nadiye Özer& Makbule Batmaz Öğle Yemeği / Lunch Sözel Bildiriler / Oral Presentations Moderatörler / Moderators : Seher Ergüney &Nevin Onan Çalışma Grupları / Workshops C SALONU / C HALL B,C,D,E,F,G SALONLARI / B,C,D,E,F,G HALLS Gala Yemeği / Gala Dinner 13

14 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS BİLİMSEL PROGRAM / SCIENTIFIC PROGRAM 4. Gün / 7 Ekim 2012 / 4 th Day-October 7, 2012 A SALONU / A HALL İkili Konferans / Dual Conference : Mobbing / Mobbing Moderatörler / Moderators : Münevver Akın&Meryem Sifil Konuşmacılar / Speakers : Mobbing / Mobbing Hüseyin Gün Mobbingin ruh sağlığı üzerine etkileri / The effects of mobbing on mental health Nermin Gürhan Kahve Arası / Coffee Break Panel / Panel : Hastaneden Eve, Bakımda Engel Yok From hospital to home, no barrier in care Moderatör / Moderator : Esra Engin Konuşmacılar / Speakers : Şizofrenik Bozuklukta Evde Bakım Hizmetleri ve Psikiyatri Hemşireliği / Home care in schizophrenia and psychiatric nursing Şeyda Dülgerler Duygu-durum Bozukluklarında Evde Bakım Hizmetleri ve Psikiyatri Hemşireliği / Home care in mood disorders and psychiatric nursing Gülseren Keskin Evde Bakım Hizmetlerinde Aile ve Psikiyatri Hemşireliği / Family in Home care and psychiatric nursing Serap Yıldırım PHD Ödül Töreni & Kapanış Award Ceremony of PHD & Closing Sosyal Program / Social Programme Erzurum Kalesi Çifte Minareler ve Medreseler Yakutiye Medresesi Arkeolojik Müze Aziziye ve Nene Hatun Fabyası 14

15 15

16 Konuşma Metinleri / Speaker Texts

17 MODERN BAŞARI-YÖNELIMLİ TOPLUMLARIN ÇALIŞANLARI, HASTALARI VE ÜYELERİNİN BOZUKLUĞA ÖZGÜ DAVRANIŞLARININ ÖNLENMESI İÇİN KATILIMCI VE BÜTÜNLEŞTIRICI ÖNLEMLER PARTICIPATIVE AND INTEGRATIVE MEASURES FOR THE PREVENTION OF DISORDER-SPECIFIC BEHAVIOUR OF STAFF, PATIENTS AND MEMBERS OF THE MODERN ACHIEVEMENT-ORIENTED SOCIETY Iris Mayenburg Altwarg European Nurse Directors Association As providers of healthcare services, we find ourselves ever more exposed to the phenomenon, that we are experiencing a substantial increase in depression, stress-situation and burn-out symptoms. These conditions create a great challenge to health policy in the current achievement-oriented society. The statutory health insurers in Germany have been reporting, for some years, an alarmingly high increase in these diagnoses. Looked at statistically, about 450 million people are suffering worldwide from mental complaints. Thus, this represents 12% of all illnesses. In the forefront are depression and anxiety disorders and illnesses. The current situation is that, already in Northern Europe, approx. 30% of all patients contact their General Practitioner in relation to emotional problems. The WHO reckons that, by 2030, depression will be the most common illness. Healthcare and Nursing find themselves challenged by this development in two, or even three, ways. On the one side, psychiatric-specialist nursing expects a different patient-clientele in the near future. In this case, it is so, that new treatment concepts will have to be developed. At the same time, in general nursing and counselling, these types of illness (which will be either caused by or be made more acute by stress) will form a growing proportion of the total work. On the other hand, the healthcare professions themselves form one of the main groups at risk from these kinds of illness. The positive results in Resilience Research, however, can play their part in counteracting the above-mentioned disturbing development. The capacity for crisis management can be acquired, to a great extent, using socially mediated processes in personality development. As a result, for the Profession of Care, three important fields of activity should be mentioned: In the framework of Personnel Management, it is for nursing managers to introduce and implement work structures which create and develop resilience. In the future, nursing theories and concepts must take much more into account these important individual resources of the patient. This is especially true for further development of fundamental theoretical knowledge in the field of specialised psychiatric care. As a final point, the findings on resilience should be implemented in all the areas where nursing healthcare counselling is applied. Resilience research can now accurately determine which personality factors lead to the ability to manage crisis situations. The so-called seven pillars of the Resilience Concept consist of Optimism, Acceptance, Solution-Orientation, Elimination of Playing Victim, Assuming Responsibility, Network-Orientation and Future Planning. For professional nursing it is now the task to encourage and strengthen those pillars in the three different areas of responsibility as follows : Nursing management concepts can draw on the extensive results and experience of new ideas in healthcare policy at the workplace. Ever since the first findings of Antonovsky s Salutogenesis there have been numerous concepts developed with promising results. Unfortunately, exactly in the area of healthcare providers have these management concepts been only infrequently implemented in Germany. A prominent role can be played, accordingly, in participation in the operational decisionmaking process. Specialised psychiatric nursing is facing increasingly a patient clientele that has high aspirations for taking part personally in the healing process. In this case, it is, from the side of the care giver, to give support to the patient in the development and consolidation of resilience-enhancing skills. In this connection, a very promising field is the so-called mindfulness training. Even though first findings to this theme exist, it is still necessary to bore deeper in the relevant nursing theory. The informed patient is to be found, now days, in all sectors of healthcare. Numerous studies have shown that the input of so-called health literacy can make an important contribution 17

18 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS to recovery and health maintenance of patients. Accordingly, the advice to patients and their families/friends is now an indispensable part of nursing care. A genuine mediation of healthcare competences, however, can never consist of just providing the facts but must always include the strengthening of the overall personality KAYNAKLAR / REFERENCES 1. Datei/4523/TK-Medienservice Mai2009 Stress.pdf (Zugriff ) Lösel, F. / Bender, D. (1999): Von generellen Schutzfaktoren zu differentiellen protektiven Prozessen: Ergebnisse und Probleme der Resilienzforschung. In: G. Opp / M. Fingerle /A. Freytag (Hrsg.): Was Kinder stärkt: Erziehung zwischen Risiko und Resilienz. München: Ernst Reinhardt, Wolter, Birgit: Resilienzforschung das Geheimnis der inneren Stärke in: systhema 3/2005; S Badura B., Hehlmann T., Walter U., (Hrsg.) (2010): Betriebliche Gesundheitspolitik. Springer: Berlin. 6. North, Klaus: Die Gesundheitshebel. Partizipative Gesundheitsförderung in der Pflege. In: CNE.fortbildung 03/2012;S Michalak, Johannes; Heidenreich, Thomas; Williams, J.M.G.: Achtsamkeit; Göttingen Osterbrink, J.: Gesundheitskompetenz. Informierte Entscheidungen treffen. In: Die Schwester Der Pfleger 51. Jahrg. 06/12; S Further Literature: files/ pdf 18

19 TESPİT YÖNTEMLERİ KLİNİKLER VE ÜLKELER ARASINDA NİÇİN FARKLIDIR, ŞİMDİYE KADAR BİLDİKLERİMİZİN BİR ÖZETİ WHY RATES OF RESTRAIN AND CONTAINMENT METHODS DIFFER BETWEEN WARDS ADN COUNTRIES, A SUMMARY OF WHAT WE KNOW SO FAR Len Bowers Professor of Psychiatric Nursing Section of Mental Health Nursing Institute of Psychiatry Health Service and Population Research, Kings College, London Why rates of restraint and other containment methods differ between wards and countries, a summary of what we know so far. Different wards can be very different places, even when they are part of the same hospital. Sometimes it is possible for one ward to have ten times as much violence, self harm and other high risk behaviours than the ward next door. In this presentation I will explore what factors may account for these differences, why they exist, and what nurses might do to make wards calmer and safer places for patients and staff. In doing so, I will draw upon a large cross topic literature review covering violence, absconding, self-harm, suicide, special observation, seclusion, manual restraint etc. This review, ongoing for the past seven years has covered a total of 1,182 published empirical studies. I will also draw upon new findings from the HICON study, an in depth qualitative project examining patients subject to high levels of containment. To conclude I will describe some of the weaknesses of inpatient psychiatric nursing practice in the UK, and sketch out some improvements that need to be made. 19

20 II. ULUSLARARASI VI. ULUSAL PSİKİYATRİ HEMŞİRELİĞİ KONGRESİ II. INTERNATIONAL VI. NATIONAL PSYCHIATRIC NURSING CONGRESS AKIL HASTALARINDA MADDE KULLANIMINI ANLAMAK: PSİKOTİK YATAN HASTALARDAN OLUŞAN BIR GRUPTA UYUŞTURUCU VE ALKOL KULLANIMININ BAĞLAM VE MOTİVASYONLARI ÜZERINE BİR ARAŞTIRMA UNDERSTANDING SUBSTANCE USE AMONGST THE MENTALLY ILL: AN INVESTIGATION OF THE CONTEXT OF, AND MOTIVATIONS FOR, DRUG AND ALCOHOL USE AMONG AN IN-PATIENT SAMPLE OF INDIVIDUALS WITH PSYCHOTIC ILLNESS Dr Peter Phillips PhD MSc RMN FHEA Senior Lecturer in Addiction, School of Health Sciences, City University London Background Dual diagnosis (substance misuse and mental illness) is recognised as a significant clinical problem. However there is little evidence contributing to the understanding of what motivates people with psychotic illnesses to use drugs and alcohol, and in what social context. There is still less evidence concerning the correlates of dual diagnosis in in-patient settings; including the relationship between mental health service settings and the initiation and maintenance of substance misuse. This study reports the prevalence, social context of, and motivations for substance use in a sample of in-patients with psychotic illnesses. Methods and measures Staff on 9 acute mental health wards and 2 psychiatric intensive care units in North London used a Clinician Drug and Alcohol Use Rating Scale to assess whether working age in-patients with psychotic illness also met the criteria for harmful alcohol or drug use, or dependence during the preceding six months. Those meeting the criteria for harmful use or dependence were then approached to participate in the study. Participants were interviewed and asked to report on the nature, extent, social context and attributions of their substance use, and whether they had continued to use whilst an in-patient. Measures used included an Inventory of Alcohol and Drug Use Situations, a Self-Medication Questionnaire, a demographic schedule and a structured set of questions concerning substance use history and it s relationship to mental health service settings. Results All working age adult in-patients (264) were screened for a current or recent substance use disorder. One hundred and twenty nine individuals met the study criteria (48.9%), whilst a further 39 (15%) had a substance use history, but no associated impairment; of these, 102 agreed to take part in the study (response rate 79%). Those with dual diagnosis were younger on average and more likely to be male, than those with psychosis alone. The majority (76%) suffered from schizophrenia and were detained under the Mental Health Act (1983), with 19% being street homeless. A wide range of substances including opiates, stimulant substances and khat were used by participants, but alcohol, cannabis and cocaine (respectively) were the most frequently used substances. Eighty one percent of the participants reported using on the ward during their current admission, with almost half of the participants buying substances from other in-patients. Methods of using reflected the wide range of substance use reported, and included intravenous injection, chasing, and smoking. A third of participants reported feeling pressurised to buy, or use substances with other in-patients. For the majority substance use was clearly a social activity; with three quarters of the partcipants reporting that they typically used or drank with others. Sixteen percent of the participants reported typically using with other mental health service users. Two principal components analyses of use situations and self medication data each revealed three factors, explaining 68% and 66% of the variance respectively. All factors had high mean scores, and elicited motivations for substance use. They were (use related to): negative personal and social states (48% variance), pleasant social conditions (13% variance), reward (7% variance), social interaction and boredom (41%) social acceptance (14% variance), and medication side effects (9% variance). An exploratory cluster analysis aimed at identifying sub-groups with distinctive patterns of motivations for use. Scores within clusters varied, with the membership of one cluster scoring highly on all factor items while other cluster members scored low on several items, clearly influencing their motivations for use. This exploratory analysis gives some indication that there are a number of distinctive patterns of use, including people who use in a wide range of situations with a variety of motivations, those who primarily use for relief of unpleasant feelings and social anxiety, and those whose use is predominantly social. Conclusions Substance misuse is a common problem in users of adult mental health services, and innovative solutions to understand and address these problems are needed. Although it was uncommon for individuals to directly medicate the symptoms of their illness with substances, their motivations for use reflected a range of social difficulties, isolation and other affective problems. 20