https://www.um.edu.mt/library/oar/handle/123456789/112429 2026-04-15T21:25:10Z https://www.um.edu.mt/library/oar/handle/123456789/113269 Title: Aftermath of an explosion : lived experiences of compulsive hoarders Abstract: Background: This study aimed to explore the experiences of people who compulsively hoard and how they make sense of their own hoarding behaviour (HB). Research studies have revealed that people with hoarding typically collect and keep items due to their aesthetic appeal, utility, and strong emotional attachment to them resulting in clutter and limiting living spaces. This study aims to explore the lived experiences of individuals with hoarding disorder (HD). Objective: The objectives of this study were to explore: (i) what persons with hoarding behaviour perceived as the causal triggers of their behaviour; (ii) the impact of living with a hoarding behaviour on their quality of life; (iii) the coping strategies adopted by individuals who hoard, and (iv) to identify available support strategies and recommendations. Design: A qualitative approach following the principles of Interpretative Phenomenological Analysis (IPA). Setting: Depending on the participants' preferences, three interviews were conducted at the participants' homes whilst two interviews were held in a public space. Participants: Five participants with compulsive HB consisting of two females and three males Methodology: A total of five participants with compulsive HB were recruited and interviewed using a simple semi-structured interview format, designed for the purposes of the study. The resulting transcribed interviews were analysed using interpretive- phenomenological analysis. Results: Three super-ordinate themes emerged: ‘Unearthing the roots of HB, ‘Aftermath of an explosion’ and ‘Reclaiming spaces, restoring lives.’ In the first super-ordinate theme ‘Unearthing the roots of HB, the participants explained how their HB could have been triggered by poverty, attachment needs, expected behaviour and loss of a close family member. The second super-ordinate theme ‘Aftermath of an explosion’ focused on the impact of HB. Participants explained how their HB affected them emotionally, functionally, psychologically, spirituality, physically and their interpersonal relationships (participants spoke about the impact of HB on the relationships with their family members and friends). The third super-ordinate theme ‘Reclaiming spaces, restoring lives’ explored the strategies used by participants to try to cope with their HB. Conclusion: This study provides new insights into the significant reliance on HCP among individuals with HB, broadening our understanding of the necessary support systems in the context of hoarding. While HCP support can be beneficial, it is crucial to implement it in a manner that respects the autonomy and needs of the patients. Individuals with HB should be empowered to make their own decisions. The findings of this study and their implications aim to provide HCP with a better understanding of the impact of living with HB and the coping strategies employed. This understanding can contribute to the development of appropriate interventions, as suggested by the researcher conducting this study. Description: M.Sc.(Melit.) 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/113255 Title: Lived experiences of adults who have a relative with schizophrenia Abstract: Background: Adult relatives of persons with schizophrenia are ones who lived or still live with the sick person. The duties of caring for someone with schizophrenia, along with the pressures of raising a family, can have a negative impact on carers, in case the relative is the primary caregiver, leading to stress and burnout. Despite this, many Healthcare Professionals continue to focus on the "ill" person and ignore caregiver difficulties, despite the obvious need to understand and support them. There is a dearth in the literature regarding the lived experiences of the relatives of people with schizophrenia. Aim: This study explores the lived experiences of adults who have a relative with schizophrenia to acquire a richer and a better understanding on the impact of caregiving, with reference to their coping mechanisms. Design: A qualitative approach following the principles of Interpretative phenomenological Analysis (IPA) of Smith et al (2009). Setting: The study was conducted online via zoom (n=5), and within a clinic in Mount Carmel Hospital (n=1). Participants: These included six individuals who live or had live with a relative with schizophrenia. Methodology: Participants were recruited using purposeful sampling. Semi-structured interviews were audio-recorded and transcribed verbatim. Data analysis was carried out using IPA. Results: Three superordinate themes emerged from the analysis. "Psycho-social impact," "coping strategies," and "identity". Conclusion: This study provided a deeper understanding about the experience of adults who have a relative with schizophrenia. More information was acquired about the obstacles and struggles that this long-suffering population faces. Nonetheless, it has been demonstrated that, while relatives of people with schizophrenia face difficulties, many of them live on perseverance, demonstrating that in life, it is possible to be faced with thorns but choose to grow roses. Description: M.Sc.(Melit.) 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/113254 Title: Mental health professionals’ attitudes and knowledge towards patients with substance use disorder Abstract: Background: All mental health providers must be ethical and compassionate. Nonetheless, there is evidence that mental health professionals (MHPs) may have unfavorable attitudes and actions toward patients with substances use disorder (SUD). Negative attitudes can be created by a number of circumstances, the most prevalent of which is a lack of knowledge or insufficient training. This creates a sense of inadequacy in managing this particular client group. MHPs' understanding of how to collaborate with one another is a critical tool for delivering holistic care to substance misuse patients. Aim: The aim of this study is to assess MHPs attitudes about patients with SUD. Moreover, the purpose of the research study is to assess MHPs' knowledge regarding patients with SUD. Objectives: The objective of this study is to look at the associations between demographic characteristics and attitudes. Another objective is to investigate if demographic characteristics influence knowledge towards patients with SUD Design and method: In this research study, a descriptive cross-sectional quantitative study design was utilized. 299 MHPs from both in-patients and community mental health settings completed the Addiction Knowledge Instrument (AKQ-20) and the Addiction Perception Profile Questionnaire (APPQ-21), resulting in a response rate of 54%. Results: Knowledge lacked mainly among participants working in chronic wards and old age psychiatry ward. This might have been due to the fact that such participants do not come in direct contact with patients SUD. Moreover, participants working in acute, community and substance misuse setting showed to have very good knowledge about substance misuse. Overall, doctors and nurses had sufficient knowledge about patients with SUD. Difference was observed among newly qualified participants and participants with much more years of experience. Furthermore, study findings demonstrated a neutral attitude hence further research is required. Conclusion: In conclusion there are neutral attitudes among MHPs towards patients with SUD with varying levels of knowledge about the disorder. The study also uncovered some concerning attitudes and knowledge gaps with several professionals presenting limited knowledge. These findings suggest the importance of targeted education and training programs for MHPs aimed at enhancing MHPs understanding, empathy, and competence. Description: M.Sc.(Melit.) 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/113253 Title: Shouldering the role of key health professional for individuals detained on a community treatment order in Malta : mental health nurses’ experience Abstract: Background: Community Treatment Orders (CTOs) were introduced locally when the Mental Health Act was revised in 2012 and are being increasingly used in practice. Nurses are usually the appointed Key Health Professionals (KHPs) for individuals detained on CTOs. Although nurses are important stakeholders within this scheme no actual exploration of how they are coping with challenges incurred from the responsibilities of the role of KHP for individuals on a CTO has been done. Aim: This study aimed to explore the meaning that Mental Health nurses (MHNs) attribute to the experience of caring for individuals detained on a CTO. The objectives of this study were to explore the views of MHNs on CTO’s framework, identify the challenges faced by MHNs whilst caring for individuals on CTO, explore how these challenges influenced care provision, explore how they coped with emerging challenges, and identify ways to support them in their role as KHPs. Design & Method: A qualitative approach was utilised following the Interpretative Phenomenological Analysis (IPA) principles. A purposive sample of seven Mental Health Nurses acting as KPHs for individuals on a CTO were recruited. Semi-structured interviews were conducted and transcribed verbatim. Data was analysed using IPA methodology. Results: Three superordinate themes emerged namely: “Paving through Responsibilities”, “Targeting the Challenges”, and “Attempts at Maintaining Balance”. The first super-ordinate theme “Paving through Responsibilities” produced two sub- themes, “Juggling between Care and Control” and “Therapeutic Relationship is Key”. The participants imparted how they regarded the CTO as a measure to support, protect and ensure treatment compliance for patients with severe mental illness. However, participants described that combining care with coercion led to ethical dilemmas, especially when enforcing treatment. To cope with these difficulties and safeguard the therapeutic relationship, participants tried to direct any conflicts regarding treatment to the administrator of the CTO. They also empathized with and guided patients to focus on their recovery process. Furthermore, unease about possible litigation and blame was evident and to safeguard themselves, the participants tended to focus more on their legal responsibilities than their caring role. The second super-ordinate theme “Targeting the Challenges” produced three sub- themes mainly “Involvement in Care Decisions”, “Resources” and “Validation and Understanding”. The participants shared their views on how the existing clinical practices are affecting care provision, the service users, and themselves as KHPs. The difficulties experienced by MHNs resulted from the complexity of their role, patient-related aspects, procedural issues, and system insufficiencies, which left the participants feeling unsupported and burdened with all the caring and legal responsibilities. Moreover, findings hinted that care planning within the local care context is focused on risk and is gripped by a blaming culture leading the participants to experience persistent emotional distress and exposing them to higher burnout risks. The final superordinate theme “Attempts at Maintaining Balance” produced two sub- ordinate themes, “Support Systems” and “Hear Us Out”. Effective dynamics and cultures within the team and reflective practice were regarded as major support structures and helped participants to cope with difficulties. Moreover, participants regarded relatives as partners in care and viewed their contribution as essential for both themselves as KHPs and for patients’ recovery process. Conclusion: MHNs described that caring for patients within CTO’s framework is indeed a complex and challenging endeavour. Participants described how the coercive aspect and legal obligations challenged their caring role and the therapeutic relationship. Furthermore, the study’s results showed that work approaches and systems’ culture could influence the provision of care and professionals’ psychological well-being. Recommendations from these findings point to a need for change in the present modus operandi and the availability of more support for MHNs to deal with challenges within the CTO framework, which will ultimately result in improved patient care outcomes. Description: M.Sc.(Melit.) 2023-01-01T00:00:00Z