Dissertations / Theses on the topic 'Centredness'
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
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Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
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Mpolweni, Nosisi Lynette. "The reader-centredness of translated financial texts into isiXhosa." Thesis, Link to the online version, 2005. http://hdl.handle.net/10019/1123.
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Buchholz, Andrea. "Students and users in the construction of the virtual university." Thesis, Brunel University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247538.
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Mabeqa, Thokozile Valencia. "The reader-centredness of translated HIV/AIDS texts into isiXhosa." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50514.
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Thesis (M.Phil.)--Stellenbosch University, 2005.ENGLISH ABSTRACT: HIV/AIDS is a disease that affects millions of people in South Africa. Various strategies have been implemented to try and curb this epidemic. One of the strategies 'used is the dissemination of information pertaining to the prevention of contracting HIV/AIDS. One of the measures of disseminating such information is through pamphlets and brochures in all eleven official languages of South Africa. This research endeavours to establish whether translated HIV/AIDS brochures are communicative towards its target readers or not. The aim of producing these brochures is to educate people about ways to prevent the spread of HIV/AIDS. On investigating translated Xhosa HIV/AIDS brochures, the researcher established that some brochures are poorly translated and fail to accomplish their purpose. Various factors contribute to the non-communicativeness of these brochures towards their intended target readers. The microstructure as well as the macrostructure of the texts tend to be problematic as far as understanding and reader-friendliness are concerned. In the end the people for whom these texts are intended do not understand the information they so desperately need. The skopos theory has been recommended by functionalist scholars as an appropriate translation approach, as it considers the culture of the target readers as well as the intention of the text. It is also concerned with whether target readers actually understand the target text. Therefore the skopos theory is promoted in this thesis for the translation of informative and instructive medical brochures and pamphlets, especially those translated into Xhosa.
AFRIKAANSE OPSOMMING: MIV/VIGS is 'n toestand wat miljoene mense in Suid-Afrika affekteer. Verskeie strategieë is reeds geïmplementeer om hierdie epidemie te probeer beheer. Een hiervan is die verspreiding van inligting met betrekking tot die voorkoming van MIVNIGS. Inligting oor die voorkoms en beheer van MIV/VIGs word, onder andere, versprei deur middel van pamflette en brosjures in al elf amptelike tale van Suid-Afrika. Hierdie navorsing probeer vasstelof vertaalde MIVNIGS brosjures effektief met hul teikenlesers kommunikeer. Die doel van hierdie brosjures is om mense op te voed oor maniere om die verspreiding van MIVNIGS te bekamp. Deur 'n studie te maak van vertaalde Xhosa MIVNIGS brosjures, het die navorser die slotsom bereik dat sommige brosjures baie swak vertaal word en daarom nie hul doel bereik nie. Verskeie faktore dra by tot die gebrekkige kommunikasie tussen vertalers van hierdie brosjures en hul teikenlesers. Die mikro- sowel as die makrostruktuur van die tekste skep probleme met betrekking tot begrip en lesersvriendelikheid. Uiteindelik kry die persone wat die inligting desperaat benodig, nie toegang daartoe nie. Die skoposteorie word as die aangewese benadering aanbeveel deur kenners van die funksionalistiese vertaalteorie, aangesien dit die kultuur van die teikenlesers sowel as die doel van die teks in ag neem. Hierdie benadering het ook ten doel dat die teikenlesers werklik die teks sal begryp. Die skoposteorie word dus in hierdie tesis voorgehou as die geskikte benadering vir die vertaling van informatiewe en instruktiewe mediese brosjures en pamflette, veral in Xhosa.
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Rosewilliam, Sheeba Bharathi. "The influence of patient-centredness during goal-setting in stroke rehabilitation." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7033/.
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Background: Guidelines suggest that rehabilitation for people with stroke should adopt patient-centred goal-setting (PCGS). Methods: A literature review and two qualitative studies were done in an acute stroke-unit. Study one aimed to explore influence of PCGS within stroke rehabilitation. Patients with stroke, with ability to participate and staff caring for them were included. Data collection involved interviews, observations, document analysis and focus-groups. Analysis involved sequential and intra-case analysis methods. Study two aimed to build a resource to improve PCGS and evaluate its feasibility and appropriateness. Based on Study one and review, a resource (T-PEGS) was developed and applied in this setting. Patients with same criteria as Study one and staff who agreed to act as keyworkers were recruited. Data collection and analysis methods were similar to Study one. Findings: Study one, with thirteen patients and twelve professionals, revealed limited application of PCGS due to participants’ health beliefs, limitations in knowledge and resources. Study two involved five patients and five staff who applied T-PEGS; recording of psychosocial goals, information sharing and rapport between patients and professionals had improved. Conclusion: T-PEGS seemed to improve PCGS locally. Small study-size and single site limit generalisability. Future work should explore mechanisms and effectiveness of T-PEGS.
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Netto, Julie Ann. "Vocational recovery in mental illness - the gap between policy and person-centredness." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/901.
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Vocation has been described as a calling and a means of fulfilment; and personal recovery as the process of living life as well as possible. Vocational recovery can be envisaged as a person with mental illness regaining or establishing valued roles associated with vocation as it is broadly defined. This thesis explores how people with mental illness establish and achieve their vocational recovery goals within the context of complex and ever-changing policy and service settings.
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Waters, Rebecca Adriana. "Person-Centredness In Human Services: An Evidence-Based Conceptualisation To Inform Practice." Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/76906.
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The term ‘person-centred’ is increasingly used in human services to define desirable approaches to service delivery for vulnerable groups of people. This multi-stage, iterative study uses a post-structuralist approach to build a conceptualisation of person-centredness with relevance across the ageing, disability, and mental health sectors. The resultant framework and conceptual model informs the application of person-centredness across policy, organisational and front-line practice contexts.
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Furler, John. "Chronicity and character : patient centredness and health inequalities in general practice diabetes care /." Connect to thesis, 2006. http://repository.unimelb.edu.au/10187/52.
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This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.
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Kinnersley, Paul. "The patient-centredness of consultations and the relationship to outcomes in primary care." Thesis, University of Bristol, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337624.
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Kouraogo, Pierre. "Learner-centredness and English as a foreign language : curriculum renewal in difficult circumstances." Thesis, University College London (University of London), 1987. http://discovery.ucl.ac.uk/10019653/.
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Wang, Qiang. "Primary EFL in China : teachers' perceptions and practices with regard to learner-centredness." Thesis, University of Warwick, 2007. http://wrap.warwick.ac.uk/2420/.
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The central focus of this study is to explore how learner-centredness is perceived and practised by Chinese primary EFL teachers in the recent national curriculum reform in China, which promotes learner-centred ideology in all school subjects beginning from 2001. Following an introduction to the research context, the study begins with a comprehensive literature review for the purpose of finding out where and how notions of learner-centredness originated and developed in the West from the past to the present, from general education to the field of English language teaching, along with doubts, criticisms, and confusions gathered around the ideology. This is followed by a review of studies on learner-centred educational reforms in developing countries. Chinese philosophical thoughts, traditional educational practices, and recent research efforts into learner-centred teaching are also reviewed to highlight the influence of specific cultural contexts for implementing such an ideology. To investigate the Chinese primary EFL teachers' views on and practices in learner-centredness, this study adopted a mixed mode of research methods using both quantitative and qualitative techniques to collect data in order not only to reveal the scale of impact of the curriculum reform on teachers' views and practices but also to provide an in-depth understanding of teachers' classroom behaviours with regard to learner-centredness. The study involved a large scale questionnaire survey of 1000 primary EFL teachers and 18 classroom observations of teachers acknowledged as being good teachers along with various forms of teacher interviews by which teachers' beliefs and behaviours regarding learner-centredness were studied. The main findings from the study are as follows: (1) Chinese primary EFL teachers overwhelmingly welcomed the new ideology for curriculum change while pedagogically they preferred a middle path - the teacher-directed learner-centred approach (TDLC). (2) Both their beliefs and reported practices reflected a mixture of learner-centred and teacher-centred teaching. (3) Classroom practices of 18 teachers representing good practices at the time of the study showed clear Chinese characteristics of teacher-directed learning centred teaching. Based on the data collected from different sources, the cultural appropriateness of learner-centred teaching in the Chinese context is discussed. A reconceptualisation of the concept for the Chinese primary EFL context is drawn from teachers' views, which contributes to a better understanding of Chinese primary EFL teachers' perceptions and practices of learner-centredness in China. The research has important implications for teacher educators in understanding and supporting teachers for curriculum change and for research into learner-centred education in different contexts as well as for research into primary EFL in other developing countries.
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Van, Aswegen Sonja-Mariè. "An analysis of learner-centredness within teacher education institutions : case study / Sonja-Mariè van Aswegen." Thesis, North-West University, 2004. http://hdl.handle.net/10394/49.
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Over the past few years many changes have taken place in the content and presentation of teacher
education programmes in South Africa due to the paradigm shift from teaching to learning. As a result,
the primary learning environment for undergraduate students, the fairly passive lecture-discussion format
where teacher educators talk and most students listen, is contrary to almost every principle of an optimal
student learning setting. The current view in teacher education is that teacher educators should create
learner-centred and learner-controlled environments where student learning and success determine the
boundary.
The idea of focusing on learning rather than teaching requires that teacher educators rethink their role
and the role of students in the teaching and learning process. When focussing on learning rather than
teaching, teacher educators must challenge their basic assumptions about how people learn and what
the roles of teacher educators should be. It may be necessary to unlearn previously acquired teaching
habits, and rethink the role of assessment and feedback in learning.
Meaningful, formative assessment can play a key role in shifting to a learner-centred approach because
it provides important information to both students and teacher educators at all stages of the learning
process. To achieve this, it is essential that teacher educators do not simply add assessment as an extra
to an existing, non-interactive scheme of work, but that they integrate assessment effectively and
efficiently with their instruction. This requires a major shift in how assessment is planned and integrated
and a working framework for integrating assessment with instruction can be most valuable to teacher
educators.
The purpose of this study was to:
Determine the nature and scope of ESL teacher educators' tasks, within a Faculty of Education Sciences, at a tertiary institution. Determine the extent to which ESL teacher educators are implementing a learner-centred approach to teaching and learning. Identify the factors, if any, that impede the transition to a learner-centred approach to teaching and learning. Provide recommendations to facilitate the implementation of a learner-centred approach to teaching
and learning.
Determine how, when and how often ESL teacher educators are currently conducting assessment.
Identify possible shortcomings of the existing assessment system of ESL teacher educators.
Provide a framework for implementing assessment within a learner-centred approach to teaching and
learning.
A one-shot cross-sectional survey design was used in this study. The participants included all the
teacher educators (N=5) within the Subject Group English in the Faculty of Education Sciences .at the
Potchefstroom University.
Three data collection techniques were used in this study, namely a questionnaire, semi-structured
interviews and classroom observations. The purpose was to triangulate the data in order to get as
complete a picture as possible of the extent to which the teacher educators' teaching and learning
~racticesre flected a focus on learner-centredness.
The results of the study can be summarised as follows:
Descriptive statistics (means and percentages) were used to analyse the data. The data collected during
the interviews were reported as narratives.
The results indicated that the teacher educators in this study spent a significant percentage of their time
on preparation for class meetings and assessment. Each teacher educator taught for the full twelve
weeks of each semester and, therefore, did not have one week free of teaching the entire year.
Although the teacher educators embraced some learner-centred methods such as group work and
interactive class discussions, they still assumed most of the responsibility for the learning processes and
classroom behaviour of the students. They mainly focused on what to present in the contact sessions
and spent time organizing presentations of information rather than developing materials to facilitate
learning. The teacher educators often reverted to more familiar, traditional approaches and emphasized
the following issues as affecting the effective and efficient transition to learner-centredness: curriculum
coverage and lack of time, lack of proper training, size of student groups, other teacher educators'
cynical attitudes and students' attitudes towards learning. The teacher educators made use of a variety of assessment methods and assessed students continuously, but these assessments were not used for promoting student learning, but rather for grading purposes. Students received traditional feedback such as grades, marks and scores, but they seldom received feedback on what they did wrong and how they could rectify it. Overall, it was assessment of
learning and not assessment for learning.
A major factor impeding the implementation of a learner-centred assessment approach was the demand
formative assessment methods placed on the professional time of the teacher educators. In order to
utilise time effectively and integrate assessment with the instructional design, teacher educators expressed the need for a workable framework to assist them in planning their assessment practices.Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2004.
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Park, Miriam Sang-Ah. "Family centredness and democratisation across cultures and generations : investigation of the impacts of macro- and individual-level factors." Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/6452.
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What are the factors that shape views and attitudes toward the family, and how are these views and attitudes influenced in changing cultures? Do culture, social change/economic development, childhood experiences, and gender influence family centredness and democratisation? Are there different levels of factors that impact on family centredness and democratisation? If so, how are these factors interlinked? The studies discussed in detail in this thesis investigated family perceptions across cultures and generations, looking closely into specific aspects of family views and attitudes and various factors that impact on them. This thesis attempts to answer these questions by conducting three experiments. Study I (described in Chapter 3), which was conducted in Hungary, South Korea, and Canada (total N=403), tested a hypothesised model based on the literature review (Chapter 2). The study looked at cultural differences in family centredness and democratisation, and the impact of cultural orientation, gender, economic growth (national-level), Postmodernist Values, and political beliefs on perceptions of family centredness and democratisation. Study II (described in Chapter 4), conducted in the US and South Korea amongst young individuals in their late teens or early twenties, and their parents' generations, mostly in their forties and fifties (total N= 230). It expanded on the model by adding Schwartz' value dimensions, self-beliefs, and broader aspects of family perceptions. Furthermore, Study II investigated the intergenerational differences and the impact of childhood experiences by comparing data from two generational groups. Study III (Chapter 5) was conducted in four cultures, Canada, Britain, South Korea, and Japan on 539 university students, in order to ascertain cultural influences on values, beliefs, and family centredness and democratisation. Study III also investigated the interlinks between the factors in each culture more specifically using multi-group analysis method in SEM (Structural Equation Modelling). The final chapter summarises and discusses the implications of the major findings from these studies, and makes note of possible methodological issues. Overall, cross-cultural differences in value priorities, self-beliefs, political beliefs, and perceptions of family centredness and democratisation were found. Generation/age, country-level economic growth and gender were significant predictors for values, beliefs and family views and attitudes discussed in this work. Women and younger generations were more likely to endorse the Autonomous-Related Self-belief, believe in the importance of family democratisation. Stronger belief in the Autonomous-Related self led to higher emphases on family centredness and democratisation. Significant relationship was also found between family centredness and democratisation and individual-level values and beliefs, where stronger democratic beliefs led to stronger belief in the importance of family democratisation, higher endorsement of Self-Transcendence values predicted higher levels of family centredness and democratisation, and stronger Consevation Values predicted higher level of family centredness. By investigating factors influencing family centredness and democratisation, the current work probed into the family in the contemporary world. In line with Kagitcibasi's new model of family change, this thesis demonstrates that certain features of family views and relationship, including perceptions of family centredness, are likely to persist, and contends the individualisation theorists' (e.g., Beck, 1997; Giddens, 1992) negative predictions for the future of the family.
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Lane, David. "Child-centredness in decision-making in public child law proceedings in England and Wales : perspectives of the judiciary." Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3022833/.
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The aim of this research was to identify the core components of child-centred decision-making in public child law proceedings from the perspectives of judges in England and Wales. In the context of this study, child-centredness includes the elements of, transparency, being informative, child-friendly and respectful of children, inclusive, safe and sensitive to risk. This aim was achieved through exploring with judges their perceptions of what represents a child-centred public child law system, by identifying those factors, such as, human, legal, cultural and systemic, which present both enablers and barriers to a transparent child-accessible and child-friendly process and system. Judges' views were also obtained on the principles underpinning legislation that may conflict with child-centred decision-making. This is a qualitative research study and involved carrying out one-to-one semi-structured interviews with 30 judges from the high, county and district courts (now the Family Court) throughout England and Wales. The inclusion criteria for this study was that the participating judges had experience of and were currently involved in presiding over public child law proceedings. The interviews were recorded using a digital voice recorder for the purposes of accuracy and subsequent analysis. Underpinning the qualitative approach chosen for this study, is the paradigm of interpretative phenomenology, the goal of which, in this study, was to describe and interpret accurately the lived experiences and perspectives of judges. Judges in this research were deeply committed to making the right and just decision for children in terms of their welfare and development. The principle of paramountcy guided them in their decision-making. This research found that children's views, wishes and feelings were mainly communicated to the court via proxy accounts of the child's appointed Guardian. For the most part, their direct voice in proceedings was silent, as judges very rarely met with the child. Children's direct participation in their proceedings was neither promoted or encouraged by judges. On the rare occasions it did occur, it was instigated by the child's Guardian. Judges felt that Guardians were spending less time in working directly with the children they represented due to a lack of available time, formal working practices and statutory timescales for the completion of proceedings, all of which impacted on the quality and analysis of evidence and information presented to the court. The research indicates that obtaining the child's perspective of their lived experience and circumstances is not a priority. The centrality of the child's position in their proceedings has been supplanted by legal, procedural and administrative requirements. The system itself has attained the status of paramountcy. The lack of transparency and inclusiveness distances the child from their proceedings.
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Shapii, Aspalila. "Learner-centredness in Malaysian year five primary school teaching : four case studies of teachers' practices, beliefs and knowledge." Thesis, University of Leicester, 2014. http://hdl.handle.net/2381/28722.
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This study was undertaken to explore and describe how English language is being taught and how the curriculum guidelines that emphasise learner-centredness are being interpreted by teachers in primary schools in Malaysia. Specifically, it focuses on whether teachers implement learner-centred classroom practices and describes teachers’ knowledge and beliefs about learner-centredness. Finally, the study focuses on teachers’ views on possible issues and challenges in implementing learner-centred approaches in Malaysian primary English classrooms. Four teachers from different school categories in a northern state in Malaysia participated in this research representing rural, town and two vernacular schools (Chinese and Tamil). Using ethnographic approach, the study involved qualitative/ exploratory approaches by documenting, describing and analysing data gathered from semi-structured interviews, observation plus note-taking, video-recording of classroom and video-stimulated recalled interviews. Findings indicate that teachers did not fully embrace the principles of learner-centredness but minimally integrated some learner-centred practices at varying degrees particularly in allowing more learner participation, introducing varied materials and activities, introducing activities that involved some discussion and discovery and encouraging interactions between learners and teachers in the target language. The findings also found some efforts to encourage self and peer-evaluation. Two fundamental principles of learner-centredness i.e., collaboration and negotiation of learning objectives and identification of learner objective and subjective needs were not found in any of their practices regardless of the school categories. Teacher’s interpretations of learner-centredness revealed superficial understanding about learner-centred practices. Consequently, recommendations were proposed in terms of improved teacher training, an outline of an idealised working construct and definition of learner-centredness to use in ELT classroom, areas of change needed in the education system in Malaysia and future research areas to investigate learner-centredness.
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Ferreyra, Galliani Mariella. "Cultural Competency in the Primary Health Care Relationship." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23467.
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Cultural competency is theorized as the sensitivity of practitioners from the dominant culture towards the diverse cultural backgrounds of their patients. Less attention is placed on how communication between providers and patients can enable patients to share their health care beliefs.
An evidence review of the literature around the conceptualization of cultural competency in health care was performed, and interviews were conducted aiming to understand what immigrant patients perceive as culturally competent care and its effect on the relationship between them and their providers.
Definitions of cultural competence varied, and no conclusive studies linking cultural competence to improved health outcomes were found. Findings from the participant interviews helped to address gaps in the literature by confirming a preference for a patient-centred approach to culturally competent care, in addition to identifying pre-existing expectations for the health care encounter and patient-dependent factors as additional elements influencing the physician-patient relationship.
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van, Rooy Leanne. "Co-designing patient-centred communication in an Emergency Department." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/61673.
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Introduction: Patient-centred communication is vital to ensure a good patient experience in the emergency
department. Visits to the emergency department leave patients disillusioned regarding the communication
experienced and this increases patient dissatisfaction. There is a need to put the "patient" back in communication
in order to make it more patient-centred and provide the patient the opportunity to voice their individual needs
pertaining to patient-centred communication.
The aim of the study was to co-design patient-centred communication in an emergency department. In order to
reach the aim of the study the following objectives were set:
To explore current communication in an emergency department as experienced by patients and healthcare
professionals.
To collaboratively co-design strategies to enhance patient-centred communication in an emergency
department.
Research design and methods: An Experience-based Co-design has been used. Unstructured observation
was done to observe existing communication in the emergency department. Patients have told their stories
through narrative-based film interviews and healthcare professionals have been interviewed to share their
experiences regarding communication in the emergency department. The observation notes and interviews have
been shared during a Co-design event. Patients and healthcare professionals have collaboratively analysed the
data to identify key touch points and co-design strategies to enhance patient-centred communication in the
emergency department.
Results: Three (3) key touch points were identified namely; professionalism, communication and daily focus.
The patients and healthcare professionals were equal partners to change the communication culture in the
emergency department to be more patient-centred. This may lead to positive patients' experiences with an
increase in patient satisfaction.
Conclusion: The ultimate goal of this study was to raise awareness relating existing communication in the
emergency department and collaboratively plan strategies to work towards patient-centred communication.Dissertation (MCur)--University of Pretoria, 2017.
Nursing Science
MCur
Unrestricted
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Chien, Li-Yu. "Reculturing curriculum within a nursing context in Taiwan : an action research approach." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16469/1/Li-Yu_Chien_Thesis.pdf.
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The focus of this study is on curriculum change within a nursing institute in Taiwan where there is a growing demand for reform to nurse education in order to produce more competent practitioners. I conceptualised a framework to guide the transformation process in ways that were empowering, sustainable and generative. I argued that curriculum change also involves the beliefs, customs, attitudes or expectations of those who participate in the process: essentially it is a reculturing process. My conceptual framework included notions such as student-centredness, reculturing, collaborative practices and reflections, personal growth, and professional development.
A plan of action was developed based on the notions contained in the conceptual framework and carried out within an Action Research methodology. Action Research provided the mechanism by which the collaborators explored and understood their conceptions of teaching and learning and then planned and implemented action to change the current situation, and evaluate and reflect on the transformations. Strategies such as personal practical theorising, focus group, critical debate, and collaborative reflection were used to bring about the curriculum change.
The significance of this study lies in its practical contribution to all aspects of curriculum making including innovation, planning, implementation and ongoing review. Although information generated from this study is not generalisable, lessons learned from it may be utilised by other educational institutes with similar issues and similar contexts.
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Chien, Li-Yu. "Reculturing curriculum within a nursing context in Taiwan : an action research approach." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16469/.
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The focus of this study is on curriculum change within a nursing institute in Taiwan where there is a growing demand for reform to nurse education in order to produce more competent practitioners. I conceptualised a framework to guide the transformation process in ways that were empowering, sustainable and generative. I argued that curriculum change also involves the beliefs, customs, attitudes or expectations of those who participate in the process: essentially it is a reculturing process. My conceptual framework included notions such as student-centredness, reculturing, collaborative practices and reflections, personal growth, and professional development. A plan of action was developed based on the notions contained in the conceptual framework and carried out within an Action Research methodology. Action Research provided the mechanism by which the collaborators explored and understood their conceptions of teaching and learning and then planned and implemented action to change the current situation, and evaluate and reflect on the transformations. Strategies such as personal practical theorising, focus group, critical debate, and collaborative reflection were used to bring about the curriculum change. The significance of this study lies in its practical contribution to all aspects of curriculum making including innovation, planning, implementation and ongoing review. Although information generated from this study is not generalisable, lessons learned from it may be utilised by other educational institutes with similar issues and similar contexts.
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Aviles, Paula, and Isabella Ljungberg. "Naturbaserad terapi och dess betydelse för personer med psykisk ohälsa : En litteraturstudie om naturen som en resurs inom vård och behandling." Thesis, Linköpings universitet, Medicinska fakulteten, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-128797.
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Bakgrund: Naturens positiva inverkan på hälsa har belysts sedan antiken. Forskning kring naturbaserad terapi har ökat de senaste decennierna och terapiformen har gett positiva effekter för flertalet patientgrupper. Mer än en tredjedel av EU:s befolkning lider av någon form av psykisk ohälsa och många går utan adekvat behandling. Omvårdnad vid psykisk ohälsa ska enligt riktlinjer innefatta ett personcentrerat förhållningssätt och utformas utifrån kunskap om vårdmiljöns betydelse. Syfte: Att beskriva betydelsen av naturbaserad terapi för personer med psykisk ohälsa. Metod: En allmän litteraturstudie med systematisk ansats genomfördes. Artikelsökning gjordes i PubMed, Cinahl, AMED, PsykInfo och Scopus. Valda artiklar kvalitetsgranskades och analyserades utifrån kvalitativ innehållsanalys. Resultat: Den naturbaserade terapin hade en positiv inverkan på hälsa för personer med psykisk ohälsa. Resultatet baserades på 17 artiklar och speglades i fyra kategorier: naturen som tillflyktsort, betydelsen av social kontext, förändrad syn på livssituation samt symtomförbättring och dess konsekvenser. Konklusion: I studien framkom att naturbaserad terapi kan ha stor betydelse för tillfrisknande och daglig funktion för personer med psykisk ohälsa. Studien visar även att omvårdnad som utgår ifrån ett salutogent perspektiv i en terapeutisk naturmiljö bidrar till en förbättrad psykisk hälsa.Background: The positive impact of nature on health has been highlighted since ancient times. The scientific research about nature-based therapy has increased during the last decades and has presented positive effects for patients with different diagnoses. More than one third of the European Union population suffers from some kind of mental illness and many lack adequate treatment. Nursing care of mental illness should according to guidelines include a person-centered approach and knowledge about the significance of the care environment. Aim: To describe the impact of nature-based therapy for people with mental illness. Method: A general literature study with a systematic approach was conducted. The search for articles was made in PubMed, Cinahl, AMED, PsykInfo and Scopus. The quality of the selected articles were examined and analyed using qualitative content analysis. Results: Nature-based therapy had a positive impact on health for people with mental illness. The result was based on 17 articles and four categories were identified: nature as a refuge, the importance of social context, altered view of life situation and improvement of symptoms and its consequences. Conclusion: The findings conclude that nature-based therapy can have an impact on recovery and daily function for persons with mental illness. The study also revealed that nursing care with a salutogenic approach in a therapeutic nature environment leads to an increased mental health.
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Chiang, Ching-Kuei. "Introducing action research as a vehicle to bring about change to a psychiatric nursing curriculum in Taiwan." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/41704/1/Ching-Kuei_Chiang_Thesis.pdf.
Full textAbstract:
The focus of this study is on curriculum change within a School of Nursing in Taiwan where there is a growing demand for educational reform in order to meet the new accreditation standards and demands of the Taiwan Nursing Accreditation Council (TNAC). The aim of this study was to transform the Psychiatric Nursing curriculum in ways that are empowering, generative and sustainable. This study introduced Action Research as a vehicle to bring about curriculum transformation. I conceptualised a framework to guide the transformation process based on the notions of learner-centredness, conceptual change, pedagogical knowledge, reflection, collaboration, reculturing and empowerment. The Action Plan was developed in accordance with the conceptual framework, and was developed in five steps through which team members explored and became aware of our conceptions of teaching and learning, and then planned and implemented actions to change our curriculum, and examined and reflected on the curriculum transformation. The study demonstrated the value of working collaboratively to solve educational problems. This study also suggested that experiential knowledge, when shared and integrated with theoretical knowledge, can constructively contribute to all aspects of curriculum transformation. This study further supported the value of including clinical facilitators in the development and transformation of curricula. It confirmed that academics and clinical facilitators can work together to create new learning for students. This study is significant for both practical and political reasons. Its practical significance lies in its direct utility to the learners and teachers who were involved in the study. The political significance lies in the potential of the study to lead to further changes or improvements in other, similar contexts. The study is limited in that any interpretations cannot be generalised to other contexts. However, what emerged adds to the body of knowledge in such a way that it would constitute the basis for better informed educational practice.
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Sparks, Candice Leah. "Teacher reaction to and understanding of a task-based, embedded syllabus." Thesis, Queensland University of Technology, 2006. https://eprints.qut.edu.au/16524/1/Candice_Sparks_Thesis.pdf.
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This thesis investigates where the Years 4-10 Queensland French Syllabus is receiving support, by investigating groups of teachers with shared characteristics. In doing so, it aims to shed some light on why teachers have not embraced this new syllabus. Specific issues pertaining to the syllabus are investigated, such as the use of task-based instruction as the chosen methodology and of embedded content, as well as contextual issues, such as employment sector and levels taught. Teachers' reactions to change have also been investigated in relation to the introduction of this syllabus. In addition to this, the process involved in acceptance of an innovation has been explored which led to an examination of teacher understanding of the current syllabus. This study is divided into five chapters. Chapter one outlines the syllabus and context, as well as hypotheses for this study and rationale. Chapter two is a literature review which brings together previous research and links it to the current study. The chosen methodology is covered by chapter three, with chapter four being a detailed explanation of results received from the data collection. The final chapter, chapter five, discusses these results and the implications of these findings.
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Sparks, Candice Leah. "Teacher reaction to and understanding of a task-based, embedded syllabus." Queensland University of Technology, 2006. http://eprints.qut.edu.au/16524/.
Full textAbstract:
This thesis investigates where the Years 4-10 Queensland French Syllabus is receiving support, by investigating groups of teachers with shared characteristics. In doing so, it aims to shed some light on why teachers have not embraced this new syllabus. Specific issues pertaining to the syllabus are investigated, such as the use of task-based instruction as the chosen methodology and of embedded content, as well as contextual issues, such as employment sector and levels taught. Teachers' reactions to change have also been investigated in relation to the introduction of this syllabus. In addition to this, the process involved in acceptance of an innovation has been explored which led to an examination of teacher understanding of the current syllabus. This study is divided into five chapters. Chapter one outlines the syllabus and context, as well as hypotheses for this study and rationale. Chapter two is a literature review which brings together previous research and links it to the current study. The chosen methodology is covered by chapter three, with chapter four being a detailed explanation of results received from the data collection. The final chapter, chapter five, discusses these results and the implications of these findings.
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Kjeldmand, Dorte. "The Doctor, the Task and the Group : Balint Groups as a Means of Developing New Understanding in the Physician-Patient Relationship." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6937.
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The general practitioner has a central position in the health care system, but demands have increased and there are signs of exhaustion in the corps. Patient-centredness is beneficial for the patients and probably for the outcome of health care. In Balint groups general practitioners study and gain further understanding of the physician-patient relationship by means of the participants’ own experiences. This thesis aims at studying experienced effects of Balint groups on the working life of general practitioners. General practitioners with and without Balint group experience are compared by means of a questionnaire, using statistical methods. General practitioners with Balint group experience are interviewed. Both these studies show positive experiences of Balint group participation in the physicians’ working life in terms of feeling of control and satisfaction, and on relations to patients, particularly patients with complex problems. A new instrument for measuring physicians’ degree of patient-centredness is presented. It can be used in groups of physicians to evaluate training programmes or by the individual physician to detect decline in patient-centredness as an early sign of burnout. Balint groups are viewed critically in interviews with Balint group leaders, focussed on difficulties and dropouts from the groups. Balint groups are found to fit into modern theories of small groups as complex systems, submitted to group dynamics that are sometimes malicious. Professionally conducted Balint groups seem to be a gentle, efficient method to train physicians, but with limits. Participation of a member demands a stable psychological condition and an open mind, and obligatory Balint groups are questioned. The thesis concludes that Balint groups are generally beneficial for general practitioners’ working life as a means to enable the physicians endure, even thrive in their job. The method facilitates development of new understanding of the physician-patient relationship with possible positive effects for the patient as well.
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Jutterström, Lena. "Illness integration, self-management and patient-centred support in type 2 diabetes." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-67847.
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Background: Type 2 diabetes is a serious disease that is increasing globally. The focus of diabetes care has been to prevent diabetes related complications and thereby reduce mortality. An older population, the disease progression and decreased ability to perform self-management activities increases the risk for complications. Group education and patient-centred care are recommended to improve self-management through increased patient empowerment. Despite these recommendations, professionals have been reluctant to adopt these methods referring to lack of knowledge, time and tools to deliver patient-centred care in diabetes. Focusing on the patient’s illness integration process has in the literature been suggested to improve self-management and metabolic balance. Aim: The overall aim of the thesis was to describe the experiences of illness integration, self-management and support in type 2 diabetes and to evaluate the metabolic effects of a nurse-led patient-centred model for self-management support. Methods: The study setting was primary health care in Västerbotten County, Sweden. In total, 21 diabetes nurses (Study I) and 257 patients (Studies II-IV) participated in the four studies (Study II, n=44; Study III, n= 18; Study IV, n= 195). Data consisted of focus group interviews (Study I), individual semi-structured interviews (Studies II-III) and laboratory measurements (Study IV). Methods for analyses were qualitative content analysis (Studies I-III) and statistics (Study IV). Results: Study I revealed that diabetes nurses found the ideal diabetes care complex to achieve. Conflicting paradigms, power relations and departmentalisation of work were described. Study II describes a process whereby illness integration and self-management in type 2 diabetes develop simultaneously. When a turning-point occurs, people view self-management as both necessary and feasible. In study III, turning points in self-management are illuminated. Turning-point transitions include existential and emotional aspects that increase inner motivation and power for lifestyle change. Study IV evaluates the effects of a nurse-led intervention in which haemoglobin A1c (HbA1c) was significantly decreased at 12 months’ follow-up. Group intervention and individual intervention were both effective compared to traditional diabetes care. Conclusions: There is a potential for improvement of type 2 diabetes care. Increased patient-centredness is important to support patients towards illness integration and self-management. Focusing on the patients’ illness experiences, including the existential and emotional aspects of having and managing type 2 diabetes, in counselling can lead to improved self-management and glycaemic control. Patients’ experiences of illness are central to their inner motives for change, and patient-centred self-management support and patient education preferably emanate from this perspective.Bakgrund: Typ 2 diabetes är en allvarlig sjukdom som ökar globalt. Fokus i diabetesvården har varit att förebygga diabetesrelaterade komplikationer och därmed minska dödligheten. En åldrande befolkning, progression av sjukdomen samt en begränsad förmåga att utföra egenvårdsaktiviteter ökar risken för komplikationer. Grupputbildning och patientcentrerad vård rekommenderas för att förbättra egenvården genom ökad empowerment. Trots dessa rekommendationer har läkare och sjuksköterskor rapporterats vara tveksamma till dessa metoder och hänvisat till bristande kunskap, tidsbrist och avsaknad av verktyg. Att fokusera på patienters sjukdomsintegrationsprocess har i litteraturen föreslagits förbättra såväl egenvård som metabol balans. Syfte: Avhandlingens övergripande syfte var att beskriva erfarenheter av sjukdomsintegration, sjukdomshantering och support vid typ 2 diabetes samt att utvärdera effekter av en sjuksköterskeledd patientcentrerad modell för egenvårdssupport. Metod: Studierna genomfördes inom primärvården i Västerbottens läns landsting. Totalt deltog 21 diabetessjuksköterskor (Studie I) och 257 patienter (Studie II-IV), i de fyra studierna (Studie II, n=44; Studie III, n= 18; Studie IV, n= 195). Data bestod av fokusgruppsintervjuer (Studie I), individuella halvstrukturerade intervjuer (Studie II-III) och laboratoriemätningar (Studie IV). Analysmetoderna var kvalitativ innehållsanalys (Studie I-III) och statistik (Studie IV). Resultat: Studie I visade att en ideal diabetesvård är svår att uppnå enligt diabetessjuksköterskorna. Paradigmkrockar, maktrelationer och splittrade arbetsuppgifter beskrevs. Studie II beskriver en modell där sjukdomsintegration och sjukdomshantering utvecklas samtidigt. När en ”turning point” nåddes såg patienterna sjukdomshanteringen som både nödvändig och möjlig att genomföra. I studie III belystes ”turning points” och som omfattar både existentiella och emotionella aspekter som kan öka inre motivation och egenkraft att utföra livsstilsförändringar. Studie IV utvärderade 12-månaderseffekterna av en sjuksköterskeledd intervention och HbA1c sänktes signifikant. Gruppintervention och individuell intervention visades vara effektiva metoder i jämförelse med traditionell diabetesvård. Slutsatser: Det finns en förbättringspotential inom diabetesvården och ökad patientcentrering är viktig för att stödja patienter att integrera sjukdom och egenvård i livet. Att i diabetesvården fokusera på patienters sjukdomsupplevelser inklusive de existentiella och emotionella aspekterna av att leva med och hantera en sjukdom kan innebära förbättrad sjukdomshantering och metabol balans. Patienters sjukdomsupplevelser är centrala för deras inre motiv till förändring och patientcentrerad egenvårdssupport och patientutbildning bör utgå från detta perspektiv.
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Wallisch, Anne, and Kristin Paetzold. "Nutzerzentrierung in Zeiten von Social Distancing: Evaluierung eines extracurricularen Lehrformats für Studierende der Produktentwicklung." Thelem Universitätsverlag & Buchhandlung GmbH & Co. KG, 2021. https://tud.qucosa.de/id/qucosa%3A75905.
Full textAbstract:
Nutzerzentrierung in der Produktentwicklung ist ein seit Jahrzehnten intensiv beforschtes Feld mit dem wesentlichen Ziel, Nutzeranforderungen möglichst ganzheitlich zu ermitteln und beschreiben. Damit soll den potentiellen Anwendern ein Produkt geliefert werden können, das einen tatsächlichen Bedarf bestmöglich adressiert oder entsprechende Begehrlichkeiten weckt und somit einen hohen Markterfolg verspricht. In der Praxis lässt sich dennoch beobachten, dass oftmals eine eher technische Perspektive, in welcher der Mensch irgendwie enthalten ist, den Entwicklungsprozess dominiert. Der Beitrag dient als Ergebnisbericht einer praxisbezogenen, interdisziplinären Lehrveranstaltung mit dem Ziel, bereits in der akademischen Ausbildung stärker für die Anwenderperspektive zu sensibilisieren. Die im Pilotkurs partizipativ gestaltete Lehrveranstaltung zu nutzerzentrierter Anforderungserhebung wurde im zweiten Durchlauf pandemiebedingt auf Remotelehre und virtuelle Kollaboration umgestellt. Die Effekte beider Formate werden im Beitrag unter verschiedenen Aspekten bilanziert und die Ergebnisbewertung erfolgt als Reflektion des Standardcurriculums.
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Гнаповська, Людмила Вадимівна, Людмила Вадимовна Гнаповская, and Liudmyla Vadymivna Hnapovska. "Learner-centred Language Teaching: Teacher-Learner interaction Formats." Thesis, ХНУ ім. В.Н. Каразіна, 2015. http://essuir.sumdu.edu.ua/handle/123456789/60131.
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The abstract dwells on the key issues related to the necessity of changing teacher-student partnership formats in the context of learner-centred approach to teaching foreign languages. The interpretation of "learner-centredness" as a concept is put into the humanistic perspective, the perspective of practical necessity, and the curriculum design perspective.Тези розглядають основні питання взаємодії викладача та студента у контексті студентоцентричного підходу до викладання іноземних мов. "Студентоцентризм" як концепт інтерпретується з точки зору гуманістичної перспективи, практичної необхідності зміни форматів співробітництва викладача та студента та перспектив розробки навчальних робочих програм з іноземних мов.
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Draper, Paul A. "New learning: The challenge of flexible delivery in higher education." Thesis, Queensland University of Technology, 1999. https://eprints.qut.edu.au/36625/1/36625_Digitised%20Thesis.pdf.
Full textAbstract:
Information technologies now enable people to communicate m real-time on a planetary scale. Previously isolated cultures have become interdependent in dynamic relationships of economy, government and society, where electronic information is a universal currency instantly distributed by a global web of inter-computer networks. Traditional labour theories of value are being rapidly superseded by knowledge value systems. Government and corporate rhetoric is now suffused with references to intellectual capital and employment opportunities that increasingly depend on people who can put knowledge to work in fluid, fast-changing landscapes. Thus, education has a critical and enhanced role in this new world order where knowledge is seen as the key to wealth and the engine of social change. By implication, universities are under increased pressure to develop and produce 'fast' knowledge workers by means of flexible formats of educational delivery. This dissertation examines the implications of these imperatives by undertaking an investigation into the professional development of the author as university teacher. The work responds to what has become known as the 'triple challenge' for universities, that is, i) to provide increased accessibility and student-centredness of higher education, ii) to achieve greater economy of operations but with less traditional sources of funding, and iii) to maintain quality, but also improve learning outcomes. The aim is to scrutinise the meaning of the terms 'flexible delivery' and 'lifelong learning' in the context of changing university structures and priorities. To do so, the author investigates teaching and learning practices that arise from within his specialist domains of professional music-making and education in music technology. The dissertation then argues the implications of this project for an overarching investigation of 'new learning' arising out of global change and its effects on all participants within the pedagogical arena - students, teachers, and the university as an organisational culture.
The research is located amid two sets of contestations - that which exists between corporate managers and practitioners, and that which exists between practical creativity and the traditional research culture. In keeping with the challenge of working in this shifting and fragmented terrain, the research methodology makes a postmodern break with traditional formats by employing a generative 'double-science' approach to practitioner-research. However, the project was not generated out of postmodern theory, but out of the 'messiness' inherent in teaching practice. It is not, therefore, a 'postmodern' project, despite the fact that postmodern scholarship informs recent developments in the author's thinking about pedagogical praxis. The enquiry strives to transcend the divides of 'science' and 'experience' by generating a confluence of knowledges, a co-authorship arising from a symbiosis of analytical scholarship and artistic creativiry. The action is about both 'doing practice' and 'troubling practice'. It acknowledges the non-innocence of any knowledge production where the practitioner is both the researcher and the researched. Central to the design is a double-pronged engagement in/with analysis/application whereby recurring themes are deconstructed in chaptered sub-cycles that spiral toward validation and theory-building. It is a reflexive process which works through compounding reconstructions of information, through re-comparisons and member-checks that provide multiple accounts of the data-as-evidence.
The dissertation argues a new logic that arises out of an explicit interrogation of the complexiry, uncertainty, and artistry of pedagogical practices in the context of the author's work. It demonstrates how flexible learning mechanisms can exist amid the artificially imposed boundaries of class segregation and discipline. In the exploration of these opportunities, it is shown that powerful new relationships can be mobilised by the supportive use of information technologies. An examination of collaborative teamwork, interdisciplinary groupings and cross-year activities suggests ways in which current demands for increased accessibility and student-centredness might be met. With its focus on improving practice, the research documents pedagogical activity that is not only generative of theory, but of learning and self-improvement. In its open-endedness, the dissertation also signals that this pedagogical project is unfinished, yet amenable to completion. It imagines a complete, yet on-going body of work that invites further experimentation, innovation and self-reflection in university teaching.
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Darwin, Zoe. "Assessing and Responding to Maternal Stress (ARMS) : antenatal psychosocial assessment in research and practice." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/assessing-and-responding-to-maternal-stress-arms-antenatal-psychosocial-assessment-in-research-and-practice(f58f4ced-df4e-49d6-ba08-24f24fade0a5).html.
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Background: Antenatal Psychosocial Assessment (APA) has recently been introduced into routine antenatal care, but the ways in which maternity service providers assess and respond to maternal stress are subject of debate. There is a lack of consensus on the instrument(s) of choice and lack of evidence regarding appropriate interventions. Further, national guidelines have not kept apace with the conceptual shift from ‘postnatal depression’ to ‘perinatal anxiety and depression’. Adopting the Medical Research Council Complex Interventions Framework, the ARMS research aimed to inform the development of interventions that support women who are experiencing, or at risk of, mild-moderate mental health disorder in pregnancy. Methods: A mixed methods approach was adopted. In the quantitative element (Study Part 1) participants (n=191) completed a questionnaire when attending for their first formal antenatal appointment, using a procedure and materials that had been previously tested in a pilot study. Details including mental health assessment and referrals were obtained from their health records, following delivery. In the qualitative element (Study Part 2) a sub-sample of women (n=22) experiencing high levels of maternal stress took part in up to three serial in-depth interviews during pregnancy and the early postnatal period.Findings: Maternal stress was found to be common. Using the Edinburgh Postnatal Depression Scale (EPDS) threshold of ≥10, approximately 1 in 4 women were classed as high depression (halving to 1 in 8 at the more conservative threshold of ≥13). Almost 1 in 3 women were classed as high anxiety, using the state scale of the State-Trait Anxiety Inventory (STAI-S, threshold ≥41), compared with 1 in 5 using the two-item GAD (threshold ≥3). Fewer than half of the women identified as high anxiety were identified by both measures. Factor analyses of the symptom measures were consistent with wider literature suggesting a three-item anxiety component of the EPDS; however, concurrent validation using regression analyses did not indicate that the EPDS could be used as an anxiety case finding instrument. Women reported that maternal stress had significant impact on their lives that may not be captured with existing clinical approaches. Women commonly found it difficult to self-assess severity of maternal stress and the assessment process could itself act as an intervention. The research provided the first validation of the depression case finding questions in UK clinical practice. The Whooley items completed in clinical practice identified only half of the possible cases identified by the EPDS, at both commonly adopted EPDS thresholds. Inclusion of the Arroll 'help' question as a criterion improved specificity of the assessment completed in clinical practice but substantially compromised sensitivity, missing 9 in 10 possible cases. Women’s mental health history and treatment history were similarly under-reported, particularly concerning anxiety. APA was introduced into routine clinical practice without attention to topics of relevance to women, context of disclosure or to provision of adequate resources for consistently responding to identified need. Women experiencing, or at risk of, mild-moderate disorder were thus usually ineligible for further support. Implications: Care pathways are needed that encompass both assessing and responding to maternal stress, where communication with health professionals, subsequent referral and management are addressed. The development, implementation and evaluation of low-cost resources embedded in such pathways are a priority and the research presented in the thesis offers a foundation on which to build.
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Dabson, Andra Maree. "Medical students, gender and patient-centredness." Thesis, 2018. http://hdl.handle.net/1959.13/1383638.
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Research Doctorate - Doctor of Philosophy (PhD)Introduction: Changes are occurring in medical education, including increasing numbers of female students and a drive to include patient-centred medicine as an important principle of health care. Methodology: This project comprises two studies investigating these aspects of medical education. The first was a qualitative study exploring medical students’ experience of gender in medicine (individual semi-structured interviews with sixteen medical students and three graduates of varying experience and backgrounds, using an iterative process of concurrent data collection and analysis). The second was a quantitative study of medical students’ attitudes to patient-centredness (using an online survey of the student population based on an existing measure, the Patient-Physician Orientation Scale). Results: Differences in experience of gender in medicine were found between male and female students, though this was generally overtly denied. Female students experience more difficulties fitting into the medical culture, and have more concerns about future careers. There were two competing gendered discourses of medical practice revealed during data analysis, “real” medicine (congruent with doctor-centred medicine) and “nice” medicine (congruent with patient-centred medicine). “Nice” medicine (patient-centredness) is seen as inherently feminine, “real” medicine as masculine, and this was part of the conflict between the discourses. This conflict was also partly maintained by differences between university teaching and hospital-based medical culture. The conflict between discourses was a cause of stress for students. Significant associations with patient-centredness were found for gender and cultural background. Female students were more patient-centred, as were domestic (compared to international) students and students of rural (compared to urban) origin. Patient-centredness was associated with preferring a community practice setting and expecting to enjoy a medical career. Discussion: Gender impacts the experience of medical education, and the level of medical student patient-centredness. A new discourse combining the strengths of the masculine “real” and the feminine “nice” medicines is needed.
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Masino, Caterina. "The Effect of Scale Centredness on Patient Satisfaction Responses." Thesis, 2010. http://hdl.handle.net/1807/24604.
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High satisfaction rates and the lack of response variability are problematic areas in survey research. An important area of methodological concern for self-report survey is the sensitivity and reliability of the instrument. This research examines the effects of a positive (right) centred scale on the distribution and reliability of satisfaction responses in a positive respondent population. A total of 216 participants were randomly assigned to one of the following three experimental Likert scale conditions: 5–point equal interval balanced scale; 5–point positive (right) packed scale; 5–point positive (right) centred scale. The distribution of responses occurred in the direction hypothesized. Comparable discrimination was found across the three conditions. Although, the study findings did not prove to be significant, the equal interval balanced scale produced the lowest mean score, contrary to previous research findings.
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Peters, Andrew Mann. "Frailty and hope as aspects of body-centredness in psalm 39." Thesis, 2008. http://hdl.handle.net/10210/217.
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The problem this research addresses is: How are people to deal with the dilemma of facing suffering in life with a body that offers restrictions both within itself and without? Can meaning be brought to the seemingly hopeless situation people find themselves in, that is, in the frailty of their lives/bodies? These and other questions arise when worshippers of God see themselves within the limited boundaries that their bodies hold for them physically, emotionally, socially and religiously. To ask these questions is to come to terms with the issue of pain and suffering of the human race in the face of a loving and caring God. Psalm 39, with its confessions of a suffering person, properly illustrates the point. Psalm 39 is analyzed by means of a socio-rhetorical approach with the emphasis on the inner, the social and cultural and the sacred textures of the text. The worshipper is characterized as a ‘holy person’ with a special relationship with Yahweh. He is also seen to have serious questions before God about life in general in the light of the severe distress/pain he experiences. He calls out for change within himself and his society. His experiences, attitude and behaviour may generically be applied to our lives today. God’s characterization has revealed that He initiates change as He deals with the root cause of the worshipper’s distress, his sin. The symbolization of God is significant in that, to a large extent, God is symbolized in this psalm in such a way as to fit the immediate needs of the worshipper. The struggle/tension that exists between the worshipper and God is a reality for us today and is a bodily issue. Often we are faced with similar difficult situations. God seems to be standing aloof while we experience severe distress that appear to originate from Him or that He allows. The answer offered by Psalm 39 is that balance in life can be found in understanding the frailty of life/the body, and experiencing the hope of salvation from Yahweh as a reality of life.Prof. J.H. Coetzee
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Hermanson, Heather Joan. "Occupational therapy client-centred practice: a deeper sense of collaboration in client-centredness." Thesis, 2009. http://hdl.handle.net/1828/3126.
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This study addressed two questions: (a) how do the various discourses that are at work
in everyday practice of occupational therapists inhibit or enhance a collaborative
therapist-client therapeutic relationship and (b) what are the ways of strategizing a more client-centred collaborative approach in the midst of the tensions and disjunctures of everyday clinical practice? These questions were addressed by analyzing narratives from the everyday practice of occupational therapy. These narratives were constructed from my own practice in order to provide an insider’s view from the clinician’s perspective, a view that is missing from the extensive literature on client-centred practice in
occupational therapy. Guided by an emancipatory interest, the study focused primarily on the tensions between dominant health care discourses that position the therapist as expert and a collaborative, egalitarian therapeutic relationship, which I called “participatory consciousness” after Heshusius (1994).
The methodology of critical reflexivity had two parts. The first was the assemblage
and interpretations of a collage for the purpose of critically examining my values, beliefs and theoretical predispositions; and the second was the critical reading and rereading of the practice narratives using as analytical tools the concepts of discourse and of occupational therapy clinical reasoning. Discourse refers to ways of thinking, feeling and acting that constitute social and cultural reality. Clinical reasoning refers to how
clinicians think in the midst of practice and was the key to identifying how the clinician consciously and/or consciously negotiated or resisted the discourses shaping the clinician-client relationship.
The study demonstrated what was entailed in the move to participatory consciousness
and offered recommendations to the profession for supporting therapists to move toward a deeper sense of collaboration within client-centred practice.
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Judisseno, Rimsky K. "Destination Strategies in Tourist Development in Indonesia, 1945–2014: Problems of Bali Centredness." Thesis, 2015. https://vuir.vu.edu.au/29726/.
Full textAbstract:
This thesis examines how Indonesian government approached tourism
development from 1945 to 2014. It shows that their focus remained on the
development of international tourism in Bali, despite the many tourism
opportunities existing throughout Indonesia. It describes how successive
governments’ policies were based on a Bali First Policy (BFP) instead of
developing multiple international tourism destinations as proclaimed in
decrees, regulations, master plans and tourism promotion and awareness
programs. As argued in this thesis, this reflected Bali’s longstanding success
as an international tourism destination. With 80% of all holidaying tourists,
Bali continues to be central to Indonesia’s tourist growth and foreign
exchange, while the tourist sector outside Bali remains significantly underdeveloped. The thesis explains the imbalance through describing and analysing the
measures taken by Sukarno, Suharto, the transition Governments of Habibie,
Wahid and Sukarnoputri, and Yudhoyono. Drawing from Easton’s Systems
Theory (1965), Butler’s Tourism Area Life Cycle (1980), and the factors
affecting tourism development identified by Ritchie and Crouch (2013), the
thesis outlines a Public Policy-based Stages of Tourism Development (PPSTD)
model that provides a better understanding of tourism policymaking
and implementation in Indonesia 1945-2014.
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Barbosa, Ana, M. Nolan, L. Sousa, and D. Figueiredo. "Person-centredness in direct care workers caring for residents with dementia: effects of a psycho-educational intervention." 2015. http://hdl.handle.net/10454/15609.
Full textAbstract:
YesThis study assessed the effects of a psycho-educational intervention on direct care workers' person-centredness during morning care to residents with dementia. A controlled pretest–posttest study was conducted in four aged-care facilities with 56 direct care workers (female, mean age 44.72 ± 9.02). Two experimental facilities received a psycho-educational intervention comprising person-centred care competences and stress management skills; control facilities received an education-only intervention, without stress support. In total, 112 video-recorded morning care sessions were coded using the Global Behaviour Scale. Both groups reported significantly higher scores on eight of 11 items of the Global Behaviour Scale and on the Global Behaviour Scale total score at posttest (F=10.59; p=0.02). Global Behaviour Scale total score improvements were higher for the experimental group, with values close to significance (F=3.90; p=0.054). The findings suggest that a psycho-educational intervention may increase care workers' person-centredness. Further research is needed to explore the long-term sustainability and extent of its benefits on workers and residents.
Foundation for Science and Technology
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Nelson, Michelle L. A. "“Until you’re there… you don’t know how you’ll be”. a phenomenological study of the influence of lived experiences on beliefs and attitudes about being a patient." 2012. http://hdl.handle.net/1993/5091.
Full textAbstract:
Canadians are worried about the future of the health care system, and provincial governments are questioning the ability of the existing system to support Canadians health care needs in the 21st Century(Industry Canada, 2011). Health care providers and system administrators are both driving and experiencing a paradigm shift; moving away from paternalism and toward an egalitarian approach. In order to practice patient centredness, health care providers must prioritize patient needs; provide information regarding treatments while taking patient preferences into account (Romanow, 2002). While there is a growing body of literature regarding patient centredness, there is scant information from the patient perspective. If the most effective and acceptable health services are those that realize the expectations of the users, this is an important area of study. Using phenomenological research methods and the theory of planned behaviour as a theoretical framework, the purpose of the study was to explore the influence of beliefs, attitudes and experiences on behaviour from the perspective of patients in primary health care or stroke rehabilitation. A second purpose was to explore the degree to which beliefs, attitudes and behaviour were similar between clinical contexts. The theory of planned behaviour was unsuitable for understanding peoples’ beliefs, attitudes and behaviour about being a patient. Being a patient was not a single, observable behaviour, but rather a set of contextually dependent strategies patients’ directed at a particular goal. The goal for each participant group was different; rehabilitation patients focused on the specific goal of recovery and discharge, while PHC patients focused on a broader goal of accessing and receiving best health care possible. These goals were reflected in their respective approaches to accessing health care services, an experience they described as socially oriented, governed and reinforced. Although patients described themselves as actively engaged, they did not approach each interaction with health care with a set of behavioural beliefs about being a patient. During the course of their participation, patients identified, developed and adopted strategies to assist in achieving the target; and evaluated those strategies more positively.
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Mfeka, Siyanda Frederick. "Teachers' understandings of the concept of learner-centredness in the revised national curriculum statement : a case study of two Durban township high schools." Thesis, 2005. http://hdl.handle.net/10413/1382.
Full textAbstract:
The qualitative case study reported in this dissertation outlines the principal findings of an investigation on four teachers' understandings of the concept of learner-centredness in the
Revised National Curriculum Statement (RNCS) in two Durban township high schools. The RNCS as the name suggests, is a revised National Curriculum that is both implemented and trialed in the General Education and Training band of schooling in
South Africa. One of the features of the RNCS is its learner-centred pedagogy. The purpose of the research was to investigate teachers' understandings of the concept of
learner-centredness in the context of outcomes-based education and the RNCS. The ways in which the meanings they assign to the concepts, as well as their perceptions of theirroles and identities in enacting learner-centred pedagogy in their classrooms as shaped by the context in which they operated was investigated A major finding of the study is that teachers' understandings of the concept of learner-centredness tend to be influenced by the context in which they work in terms of the school culture, as well as their understandings of their new roles and identities in the context of the RNCS. This means that, in part schools' cultural and social processes play a major role in shaping and reconstructing both the experiences and roles of teachers in the context of educational innovation. This has implications for the content and processes of teacher professional development and in-service education programme, as well as the organisational development of schools in preparation for curriculum change.Thesis (M.Ed.)-University of KwaZulu-Natal, Durban, 2005.
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Mkhize, Vusi Garnet. "An investigation into the adult educators' knowledge, understanding and application of the principle of learner-centredness in adult basic education and training (ABET) centres in Pietermaritzburg, KwaZulu- Natal." Thesis, 2005. http://hdl.handle.net/10413/1941.
Full textAbstract:
This study investigated ABET tutors' knowledge, understanding and application of the principle of learner-centredness. The study was conducted at three adult education centres in Pietermaritzburg, KwaZulu-Natal. Using questionnaires, interviews, classroom observation and analysis of documentary evidence such as learning programmes, tutors workbooks and learners' workbooks, the researcher was able to determine and assess the ability of ABET tutors to interpret and apply the principle of learner-centredness in practical classroom situations. The study showed that not all ABET tutors base their learning programmes on learners' needs, which is a key principle of learner-centredness (Jarvis, 1985). The study showed that some ABET tutors are not conversant with the policy framework of ABET and that this seems to affect classroom practice. The study revealed that Centre managers are not complying with Department policy with regard to monitoring and supporting tutors. Furthermore, the findings from this study expose some of the flaws in the implementation of ABET, like the lack of professional competence on the part of some ABET tutors. This lack of professional competence is cause for concern and requires attention from the ABET Directorate at district level. Key recommendations emerging from the study are that the ABET Directorate should conduct more monitoring of ABET centres and should provide more training for ABET tutors and centre mangers, as proposed in the Multi-Year Implementation Plan of 1997. In particular, tutors could benefit from workshops on needs identification and analysis.Thesis (M.Ed.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.
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Alkouri, Osama Ahmad. "Developing a Patient-Centred Management Program for People with Heart Failure in Jordan." Thesis, 2019. http://hdl.handle.net/2440/123638.
Full textAbstract:
Despite the medical advancement in heart failure (HF) management strategies, HF remains a condition that has significant physical, psychological, and social negative impacts on patients. Previous heart failure management programs have produced inconsistent results, and failed to determine an effective intervention that attains clinical stability. While the effectiveness of therapeutic options / elements for HF has been determined, a practice gap exists around how best to structure and deliver the therapeutic options. As a developing country Jordan has a limited health budget and infrastructure, as well as a lack of well-structured health care services for chronic diseases. In addition, there have been dramatic increases in prevalence of ischemic heart disease, diabetes, and hypertension, and other risk factors for heart failure (HF) attributed to sedentary lifestyles and dietary shifts. Therefore, an effective HF management program that is contextualised and feasible is needed. According to the literature, patient-centred care can be effective in improving HF knowledge, adherence to self-care, communication between patients and healthcare provider, and psychological status. Tailoring interventions is an important part of patient empowerment or patient centredness in which the interventions are specifically designed for patients based on careful assessments. This mixed methods study proposes a patient-centred HF management program that is tailored to the Jordanian context and patients’ needs. It involved two studies. The first study was a cross sectional survey. The second study comprised two components: a Delphi study of clinicians and focus groups for patients. The cross sectional study (survey) was conducted with a convenience sample of 300 Jordanian patients with HF. The outcomes that were measured included: (i) heart failure knowledge, (ii) self-care, (iii) treatment adherence, and (iv) quality of life (QOL). The Delphi study utilised seven clinicians and policy makers. The two focus groups included the same seven HF patients recruited from cardiac out-patient clinics. The main purpose for study two was to derive consensus from clinicians (using the Delphi method) and understand the perspectives of patients (using focus groups) on a more patient-centred model of HF management. Study I (quantitative study) showed that Jordanian HF patients had a moderate level of knowledge, a moderate self-care, poor adherence, and moderate quality of life. Males had higher knowledge than females. Only 3% of patients were informed to weigh themselves every day, and to watch the fluid status. Regarding self-care, most patients disagreed that they would contact their doctor or nurse if they gained 2 kg in one week (92%), and 83% disagreed with monitoring their weight every day. Unmarried and illiterate patients had poorer self-care than their counterparts. Activities with the lowest levels of adherence were: reducing or quitting smoking, and self-weighing. The predictors of quality of life were insomnia, marital status, previous hospitalisation, and employment. Regarding patients’ focus groups, eight themes emerged from the first focus group, including emotional impact of HF, Motivation to change lifestyle, Adjustment to treatment, Physical impact of HF, Loss of social interaction, and Impact of religion. Three themes emerged from the second focus group, involving the effectiveness of teaching sessions in cardiac clinic, suggestions for improving the educational program, and appropriateness of educational material. The Delphi study found consensus for the feasibility of different HF components: lifestyle brochure, nutrition card, and follow up phone call program, cardiac rehabilitation program, and group discussion session. The mixed methods study revealed that there were increased HF risk factors and sedentary behaviours for people with HF in Jordan, poor HF education, psychological distress, social isolation, and ineffective communication between patients and healthcare providers. The Jordanian healthcare system will need to implement a patient-centred heart failure management program that is tailored to Jordan context and patient’s needs. The proposed program from this study was determined to be feasible, appropriate, and applicable in Jordan, embracing three main elements that should be delivered to patients across the whole continuum of care process. These were targeted education, psychological support, and social support.Thesis (Ph.D.) -- University of Adelaide, Adelaide Nursing School, 2020
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Amponsah, Samuel. "The use of Student Teams Achievement Division as a teaching strategy in English first additional language in KwaZulu-Natal." Thesis, 2014. http://hdl.handle.net/10500/18335.
Full textAbstract:
The paradigm shift in teaching from the teacher-centred approach to the learner-centred approach in recent years has impacted on the way teachers go about their duties in the classroom. This paradigm shift necessitated this research with the aim of investigating how the Student Teams Achievement Division (STAD) technique can be used as a cooperative learning technique to teach EFAL in Kwazulu-Natal.
The purpose of this study was to design a framework for the implementation of STAD as a cooperative teaching strategy for EFAL teachers by gleaning literature on teaching and learning, cooperative learning and STAD in chapters two to four of this study. Empirical research, by way of a survey and focus group discussions were also conducted in four out of the twelve districts in the Kwazulu-Natal Province to help solidify the framework designed in this study.
In striving to get in-depth insight into this study, the post-positivist-constructivist paradigm, which calls for the mixed methods research design was employed for the collection and analysis of data. Specifically, the Likert scale survey questionnaire and focus group discussions were used to collect data, through the sequential mixed methods design for the quantitative and qualitative phases of this study respectively, from a sample of 220 respondents and twelve participants. The findings of this research indicated that the time spent in training teachers towards the implementation of the STAD technique was not adequate. That notwithstanding, it was indicative that teachers make efforts to implement the strategy in their teaching and the results proved to be very positive as the technique continues to help improve upon learners’ performances and builds in them qualities such as critical thinking skills, good discussion skills and positive collaborative learning.
In the nutshell, the literature study, the findings of the empirical research and the recommendation of this study forms the basis for designing the framework for the implementation of STAD as a teaching strategy for EFAL teachers.Curriculum and Instructional Studies
D. Ed. (Curriculum Studies)