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Introduction Psychiatric Nursing or Mental health nursing is the speciality of that cares for the people of all ages

with mental illness or mental distress. Psychiatric Mental health nursing works within nursing models utilizing care plans and seeks to care for the whole person. Mental health nurses are dealing with the most vulnerable people in society – people who are living chaotic lifestyles, people who are contemplating suicide. More performance measures are required in mental health nursing to provide a more structured view of what mental health nurse are doing. According to a study, Psychiatric Nursing is the least preferred speciality because of association with pejorative attitudes towards mental health. There is a minimum nurse-patient ratio for care hospitals of mentally ill patients. Hospitals care may be compromised by forces that have increased mentally ill patient acuity and reduced ratio of psychiatric nurses, thus lowered the care and management of nurses to mentally ill patients. According to a journal, turnover of highly skilled nurses is a problem for many psychiatric hospitals. Nurses are the frontline professional staff for psychiatric patient; without them, the provision of highly quality care is difficult. Several factors related to nurses who won’t prefer the Psychiatric Nursing field includes the nurses perception of the risk of assault by patients. Assault has been a concern for the staff in psychiatric hospitals. Other factors that influence the recruitment and retention of nurses in mental health services, these include the choice of work location, work routine, off duty/staff allocation arrangements, teamwork and environment. The researchers have observed that Psychiatric Nursing is one of the least preferred fields of speciality. We want to conduct this study because we want to identify the effects of disproportionate nurse-patient ratio, because in the care and management of psychiatric patients we focus more in the therapeutic use of self rather than pharmacological management. The researchers also wanted to conduct this study because they can easily relate it to their concept this semester, which is the care and management of Psychiatric patients.

Conceptual Framework
Patient Factors • Age • Primary diagnosis • Acuity and severity • Comorbidity • Treatment stage Hospital Factors • Size • Volume • Teaching • Technology

Medical care

Nurse Staffing • Hours/patient day: Delivered care hours Total paid hours • Skill mix • Nurse staffing ratio

Patient Outcomes • Mortality • Adverse drug events • Patient satisfaction • Nurse quality outcomes

Length of stay

Nurse Characteristics • Education • Experience • Age • Contract nurses • Internationally educated Nurses

Nurse Outcomes • Satisfaction • Retention rate • Burnout rate

Organization Factors • Clinical units • Duration of shift • Shift rotation

Theoretical Framework Many people enter the healthcare field because they want to work with people. For these nurses, it is the nurse-patient relationship that is one of the most important things. By understanding the nurse-patient relationship, nurses can be better equipped to work with their patients and, ultimately, provide better care for them. Hildegard Peplau's model of nursing focuses on that nurse-patient relationship and identifies the different roles nurses take on when working with patients. This research was anchored on the theory of Interpersonal Relations Model of Hildegard Peplau. Peplau developed the concept of the therapeutic nurse-patient relationship, which includes four phases: Orientation, Identification, Exploitation and Resolution. It is where there is an orientation where the nurse assists the client to understand the problem. Identify positive outcomes through interventions and the health benefits that the clients will gain and through use of available services ad where goals are met and new ones are adopted for continuity of care. Peplau also wrote about the roles of the nurse in the therapeutic relationship and how these helped to meet the client’s needs and its effectiveness on the client on care and management. Peplau's model for nursing, which helped later nursing theorists and clinicians develop more therapeutic interventions, includes seven nursing roles, which show the dynamic character roles typical in clinical nursing. The Seven Nursing Roles are: the stranger role, in which the nurse receives the patient the way a stranger is met in other situations, and provides an atmosphere to build trust; the resource role, in which the nurse answers questions, interprets data, and gives information; the teaching role, in which the nurse gives instructions and provides training; the counselling role, in which the nurse helps the patient understand the meaning of current circumstances, as well as

provides guidance and encouragement in order for change to occur; the surrogate role, in which the nurse acts as an advocate on behalf of the patient; the active leadership role, in which the nurse helps the patient take responsibility for meeting treatment goals; and the technical expert role, in which the nurse provides physical care for the patient and operates equipment. For those who become nurses to work with mentally ill persons, studying Hildegard Peplau's model of nursing can be very useful. By better understanding the seven roles of nursing, they can apply different roles in different situations, which will ensure that their patients receive the best care possible, and will ultimately speed along treatment and recovery. Though there are hard and fast answers in the healthcare field, it is also adaptive and nurses need to be flexible in order to provide the best care for their patients. After all, each patient is different and should be cared for based on the individual needs of that particular patient. To better understand the adaptive nature of nursing, it would help to study Sister Callista Roy's Adaptive Model of Nursing. Developed by Roy in 1976, the Adaptation Model of Nursing asks three central questions: Who is the focus of nursing care? What is the target of nursing care? and When is nursing care indicated? This model looks at the patient from a holistic perspective. The three concepts of her model are the human being, adaptation, and nursing. Under the concept of adaptation are four modes: physiological, self-concept, role function, and interdependence. The physiological mode deals with the maintenance of the physical body. This includes basic human needs such as air, water, food, and temperature regulation. The function of the mode of self-concept is the need for the maintenance of the mind. The person's perceptions of his or her physical and personal self are included in this mode. Social integrity is emphasized in the role function mode. This addresses people's adaptations to different role changes that occur

throughout a lifetime. The interdependence mode also addresses social integrity. This mode deals with the balance between independence and interdependence in a person's relationships with other people. According to Roy's model, the goal of nursing is to promote adaptation of the patient during illness and health in all four of the modes. The nurse's actions begin with assessment on two levels. First, the nurse makes a judgment as to the presence or absence of maladaptation. Second, the nurse focuses on the stimuli influencing the patient's maladaptive behaviour. The nurse then takes actions to promote adaptation by manipulating the environment, elements of the patient system, or both. Nursing is not rigid and by applying Roy's Adaptive Model of Nursing to nursing practice, we can be sure that the care we give our patients will be the highest quality we can provide for that individual patient in his or her individual situation. There are some factors that affects the nurse-patient ratio in Psychiatric health settings and this scope is anchored on Rosemarie Rizzo Parse’s Human Becoming Theory. It emphasizes how individuals choose and bear responsibility for patterns on personal health. Most nursing theories focus on either a bio-medical approach or a bio-psycho-social-spiritual approach. And while these theories are not only valid, but often very effective, there are some nurses who would prefer to focus on the quality of life of their patients, particularly from each individual patient's perspective. The Human Becoming Theory is a combination of biological, psychological, sociological, and spiritual factors, and states that a person is a unitary being in continuous interaction with his or her environment. It is centered on three themes: meaning, rhythmicity, and transcendence.

The theme of meaning says that Human Becoming is choosing personal meaning in situations, and that a person's reality is given meaning through experiences he or she lives in the environment. Rhythmicity explains that Human Becoming is cocreating rhythmical patterns of relating with the universe, and that a person and the environment cocreate in rhythmical patterns. Transcendence says that Human Becoming refers to reaching beyond the limits a person sets, and that a person is constantly transforming him or herself. In terms of nursing, the Human Becoming Theory explains that a person is more than the sum of the parts, the environment and the person are inseparable, and that nursing is a human science and art that uses an abstract body of knowledge to help people. The theory allows nurses to create a stronger nurse-patient relationship because the nurse is not focused on "fixing" problems, but is viewing the patient as a whole person living experiences through his or her environment. The Human Becoming Theory of Nursing is a model that focuses on the quality of life of the patient and sees the patient not as different aspects of a whole, but as a person. This is different than many other nursing theories, and allows nurses to do what so many of them go into the nursing field to do: help people.

Significance of the Study The findings of this study will be beneficial to the following: The Patient: As direct beneficiary of the study, mentally ill patients will be able to receive efficient care from nurses. Since this study focuses on the nurse-patient ratio, wherein there are more patients than psychiatric nurses thus it affects in the care and management of mentally ill patients. Health care need will be anticipated and will be given the satisfaction expected. Staff Nurses: The findings of the study will enable psychiatric nurses to envision themselves as efficient nurses whose aim is to deliver care and management to mentally ill patients. This will also motivate psychiatric nurses to perform well in their fields in the promotion of care and management and together with the emotional support. Hospital Administrators: The results of this study will be useful as a guide to an intervention

for improved patient care through the nurse’s efficiency. LDCU-College of Nursing: This study can be a guide to future student nurses and researchers

who would like to undertake or rather continue similar study. This study would also serve as a tool for future reference.

Sub-problems Descriptive 1. To know the nurse-patient ration in the ____________________ 2. To know the effectiveness of care ________________________ Inferential 1. Is there a significant relationship in the Nurse-patient ratio in the effectiveness of care and management when grouped according to age, gender, civil status and income among psychiatric nurses? 2. To find the difference between the effectiveness in the care and management of mentally ill patients and factors that affects nurse-patient ratio

Methodology The study employed the descriptive research design according to Wilson (2000), a descriptive research design aims to study and gain a better understanding of complex behavioural patterns and phenomena by studying the relationship between variables that are hypothesized to be related. This research design is appropriate in finding out the relationship between the characteristics of the respondents. The target population were the psychiatric nurse of House of Hope and Davao Medical Center. Purposive sampling was used in the selection of 20 respondents considering the following criteria: 1) They are currently working as a psychiatric nurse at the House of Hope and Davao Medical Center 2) The length of working at least 1 year 3) had undergone psychiatric nurse training. Research made questionnaire was developed which is consisted of two sets of questions set A and B. Set A comprises questions of the profile of the respondents and set B compromises questions on the reasons why they choose to work as a psychiatric nurse. There were simple statistical computations used in this study such as percentage and some results were simply descriptive in nature and more I the recording of data and analysis. Information classified was not subjected to computations but subjected for analysis and interpretations.

Palihog nalang kog basa ug ilisi ang mga sayop. Wala ko kita ug statistics para sato introduction. Ang conceptual framework usabon pa tana kay dili pana xa mao, ge copy ko rana sa research paper nga akong nakita sa net about staffing sa nurse and effectiveness of care. Wala pa tay questionnaire. Wednesday na raba ang deadline guys. ☺