Fasiliterende kommunikasie met die verstandelik vertraagde persoon tydens die behandeling van geringe ongesteldhede

The research objectives were to explore and describe the nature of communication with the mentally retarded adult during treatment of minor ailments; and to describe guidelines for the community nurse in order to facilitate more effective communication during the treatment of minor ailments in the mentally retarded adult for the promotion, maintenance and restoration of the mentally retarded individual’s health. The community nurse pays attention to the protection of the mentally retarded individual’s health, and identifies and treats minor ailments encountered by the mentally retarded individual. Because of the disability of the adults, lacking communication and obstacles in the exchange and interpretation of communication, could take place between the community nurse and the mentally retarded adult. The responsibility lies with the community nurse to facilitate effective communication, since the mentally retarded individual is not always capable of speaking on his/her own behalf. Guidelines are needed for the facilitation of effective communication between the community nurse and the mentally retarded adult during the treatment of minor ailments. In this research, use were made of a qualitative, exploratory, descriptive and contextual design. The research method consisted of participative observation during which video recording and the taking of field notes were applied. Two themes were identified during data analysis, namely: ^Verbal communication is aimed at the treatment of wounds. The more functional and task-orientated the community nurse’s interaction with the mentally retarded individual, the more the mentally retarded individual would generate symptoms to establish emotional contact and interaction; The non-verbal behaviour of the community nurse focuses on the treatment of wounds and organisation of the environment. The more structure is created, the more play-out-behaviour is shown by the mentally retarded individual in need of contact. The researcher came to the conclusion that the community nurse refrains form near/close contact with the mentally retarded individual, to bridge her own discomfort. The community nurse is “busy” with the act of treating wounds, in order to refrain from effective interaction.

Elimination of Chronic Self-Injurious Behavior by Withdrawal of Staff Attention

Self-injurious behavior is frequently noted in institutionalized persons. Several treatment techniques have been attempted including medication, timeout, shock, aromatic ammonia, and adaptive clothing. Several authors have suggested extinction as an alternative technique. One problem with this technique is that self-injury may occur during the extinction period. The present study suggests that staff attention may maintain self-abusive behavior and withdrawal of this attention resulted in a rapid reduction of this behavior in a retarded individual.

The Use of Mild Punishment in Combination with Reinforcement of Alternate Behaviors to Reduce the Self-Injurious Behavior of a Profoundly Retarded Individual

A procedure involving the response-contingent presentation of a mild aversive stimulus, reinforcement of alternative behaviors, and training for stimulus control was used to suppress self-injurious behavior of a profoundly retarded individual. This procedure, implemented by several people in varied settings throughout the entire school day, produced an immediate and substantial suppression effect in the training environments. Examination of school records and extensive staff interviewing indicates that the suppression effect generalized from the training environments to the hospital living area. In addition, it was durable in both the training and nontraining settings over an 8-month interval, although 20 months after treatment termination, a large portion of the generalized suppression effect in the nontraining environment was reversed. Possible explanations for this phenomenon are presented. These records and interviews also indicate that the inhibition factor of self-injurious responding was not associated with increases in existing stereotypic behavior or the development of new stereotypic behaviors. The public school personnel who conducted the program were completely trained in one school day without disruption to their normal activities.