Dissertations / Theses on the topic 'Counselling, wellbeing and community services'
To see the other types of publications on this topic, follow the link: Counselling, wellbeing and community services.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Counselling, wellbeing and community services.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Waters, Elizabeth. "Measuring child health and wellbeing." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270153.
Full text
2
Whelan, Blanche M. "The impact of counselling services at a small community college, multiple perspectives." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0033/MQ62440.pdf.
Full text
3
Van, Wyk Sherine. "Locating a counselling internship within a community setting." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/49732.
Full textAbstract:
Thesis (MA) -- University of Stellenbosch, 2002.ENGLISH ABSTRACT: no abstract available
AFRIKAANSE OPSOMMING: Hierdie navorsing ondersoek die behoefte van Sielkunde as professie om meer sosiaal relevante en gepaste dienste vir al die mense van Suid-Afrika te lewer. Dit bespreek die kritiek teen tradisionele sielkunde en die dringende behoefte vir 'n meer kontekstuele benadering om the negatiewe sielkundige verskynsels in the samelewing te begryp en verklaar. Die waarde van Gemeenskapsielkunde om voorkomende, kuratiewe en bevorderende geestesgesondheidsdienste aan gemeenskappe te lewer, word ook ondersoek. Verskeie modelle van gemeenskapsielkunde en die voorgestelde integrasie van geestesgesondheidsdienste by Primere Gesondheid word bespreek. Die plasing van 'n voorligtingsielkunde internskap binne 'n gemeenskapsomgewing, naamlik, die Don en Pat Bilton Kliniek, Jamestown, word beskryf en qeevalueer.
4
Montgomery, Anna. "Counselling in Swedish Community Pharmacies : Understanding the Process of a Pharmaceutical Care Service." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108973.
Full textAbstract:
Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge. The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies. Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to describe the content of consultations, counselling behaviour and patterns of follow-up. Further aims were to characterise patients receiving the service and describe their perceived outcomes, in relation to standard service. Data were collected via focus groups, telephone interviews, observations, a patient medication record database and a cross-sectional survey. The practitioners reported greater use of their pharmaceutical knowledge and provision of more thorough patient support. Perceived barriers in delivering the service included difficulties in documenting and getting commitment from colleagues, managers and prescribers. Doctors working close to PC pharmacies held varying opinions about the service. Consultations dealt with issues potentially improving the outcomes of medical treatment, but the level of patient centredness varied and was limited by the practitioners’ focus on the computer screen. The rate of follow-up evaluations was modest, but was higher at pharmacies with a high volume of patients receiving the service. PC patients were mostly elderly and female, using about 10 prescription drugs. In comparison to patients receiving standard service, they were more worried, vulnerable and information-seeking. At the same time, their feelings of safety following the pharmacy visit were more pronounced than those of patients receiving standard service. They also felt better prepared for doctor visits. In order for community pharmacy to better meet patients’ needs and optimise PC services, increased attention should be given to implementation strategies, interprofessional collaboration and educational efforts focusing on patient centredness.
5
Shahidullah, AKM. "Community-Based Developmental Entrepreneurship: Linking Microfinance with Ecosystem Services." International Journal of Development and Sustainabilty, 2 (3), 1703-1722, 2013. http://hdl.handle.net/1993/31836.
Full textAbstract:
This research examined whether microfinance-assisted developmental mechanisms can integrate ecological objectives alongside social and economic ones—thus promoting sustainability. The specific focus was to test the ability of microenterprises operated by community-entrepreneurs in supporting local ecosystem services. To this end, the research: elucidated the nature and dynamics of linkages between communities and the local ecosystems with the lens of coupled social-ecological systems, i.e. illustrated ecological modernization of microenterprises in a developing country context; tested how community-based enterprises transform upon application of green microfinance strategy; and then recognized how social learning is promoted through such community-based intervention mechanisms, e.g. microfinance.
The research used case study and participatory approaches. The case study comprised two components: i) a green microfinance program, and ii) communities in a riparian, and a wetland ecosystem in Bangladesh engaged in entrepreneurship. The major tools that the study employed for data collections were: household surveys, participatory land -use surveys, semi-structured interviews, key informant interviews, focus group discussions, multi-stakeholder workshops, field observations, and document reviews.
The research findings reveal that the green microfinance strategy, in the short and medium terms, catalyzes entrepreneurial and social innovations, and combine the embedded economic and social objectives of the classic microfinance with the new ecological objectives towards sustainability. The strategy applied by Microfinance Institution (MFI) and adopted by community enterprises transformed the ventures—helping them to go green and reducing greenhouse gas emission. Besides, the partnerships that occur between non-governmental organization (NGO) and community-based organization (CBO) in the process of implementing developmental programs—result social learning and innovations in the communities.
The research review found grassroots developmental initiatives as an evolving phenomenon over time. With this view, and with its observation through this cross-sectional study, the research proposes a framework entitled ‘community-based developmental enterprise (CBDE)’. The framework proposes community level entrepreneurial ventures, associated NGO-MFIs, CBOs and other development partners to consider ecosystem services and wellbeing components in entrepreneurial design and actions.October 2016
6
Taylor, Vicki. "Talking clients into tests : the interactional accomplishment and management of unsolicited 'offers' in HIV pre-test counselling interviews." Thesis, Goldsmiths College (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325354.
Full text
7
Dennis, Matthew. "The role of community-led innovation in the adaptive capacity of ecosystem services in an urban social-ecological system." Thesis, University of Salford, 2015. http://usir.salford.ac.uk/35449/.
Full textAbstract:
Urban areas are hubs of creativity and innovation providing fertile ground for novel responses to modern environmental challenges. One such response is the community-led management of urban green spaces as a form of organised social-ecological innovation (OSEI). Previous studies have attempted to conceptualise the ecological, social and political potential of such informal approaches to urban green space management. However, little work has been carried out into their efficacy in the landscape, either by describing the social-ecological conditions influencing their occurrence or by quantifying the actual benefits in terms of ecosystem service provision. This research explores the emergence and impact of OSEI in a continuous urban landscape comprising the metropolitan areas of Manchester, Salford and Trafford (UK). The social-ecological context and content of OSEI were investigated using a cross-scale approach. At the landscape scale a snowball-sampling method mapped the occurrence of OSEIs using GIS and remote sensing technology. At the micro-scale, a case study quantified relative levels of provision across four key ecosystem services. The analysis presented OSEI as an adaptive response to environmental stressors, clustered around “hubs” of social-ecological innovation in the urban landscape. The distribution of OSEIs was influenced by historical context, degree of urbanisation and dependent on levels of, and dynamics between, social and ecological deprivation. Urban agriculture was instrumental as a catalyst for the emergence of OSEI and the associated production of a range of ecosystem services. Site productivity was also influenced by spatial and design considerations. This thesis has detailed the character of OSEI as a coherent phenomenon in the urban landscape which exhibits valuable response diversity according to social-ecological conditions. This, together with an evaluation of factors influencing ecosystem service provision at the local scale, has informed the validity of OSEI as an element of adaptive capacity which contributes to resilience in urban social-ecological systems.
8
Mahajan, Shauna. "Who benefits and who loses? : Evaluating the impacts of community-based marine protected areas on ecosystem services and human wellbeing." Thesis, Stockholms universitet, Stockholm Resilience Centre, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-105721.
Full textAbstract:
Coral reef ecosystems are some of the most biologically diverse systems in the world, and provide a number of ecosystem services that humans depend on for their wellbeing. Marine protected areas (MPAs) are a social-ecological intervention that while conserving these ecosystems, also have significant impacts on the communities that depend on them for their wellbeing. Community-based MPAs are growing in popularity with the assumption that by putting communities at the forefront of their planning and management, more participation will occur, ensuring positive social and ecological impacts. This study, through mixed qualitative and quantitative methods, examines two community-based MPAs in coastal Kenya (called tengefus) to understand how each tengefu was incepted, and how resource users perceive the impacts of the tengefu on ecosystem services and human wellbeing. Participation in and donor support for the tengefu were found to influence how resource users perceived impacts. Individuals who were more engaged in the project or held some type of leadership position perceived more positive impacts on ecosystem services and human wellbeing compared to those not involved. In the two cases, tangible benefits (e.g. fisheries spillover and ecotourism) from the marine enclosure itself are too few to benefit the community as a whole. For tengefus to be social successes, more attention should be given to engaging all resource-dependent community members in their planning, implementation and management, and to understanding the multifaceted role of donor funding in supporting these initiatives.
9
Alizadeh, khoei Mahtab. "Assessing factors in utilisation of health services and community aged care services by the Iranian elderly living in the Sydney metropolitan area." University of Sydney, 2008. http://hdl.handle.net/2123/3986.
Full textAbstract:
Doctor of philosophy (PhD)Abstract As one of the most culturally diverse countries in the world, Australia has a high proportion of minority communities. However, its ageing population, particularly within these ethnic minorities, faces a range of barriers or difficulties in gaining access to and using health and aged care services. This study aims to identify the acculturation factors that affect the health status of Iranian-born elderly immigrants to Australia and their utilisation of health and community aged care services. The results of this study will be of value to Iranian elders, their families, and Australian aged health care service providers. The findings could also contribute towards enriched multicultural policy and improved social fairness, access to services, and equity for the aged from different ethnic backgrounds. 302 Iranian migrants aged 65 years who had lived in the Sydney Metropolitan area for at least six months were surveyed via a written questionnaire, face-to-face interviews, and telephone interviews. The results were analysed using SPSS and then compared to the findings from a 1999 survey of NSW elderly. The results indicate that Iranian migrants suffer higher levels of psychological distress and are more limited in their physical functioning than the general population of older Australians. They are in greater need of assistance with activities of daily living, have a lower sense of wellbeing, and are far less likely to utilise aged care services. Iranian migrant who do not speak English at home experience these disadvantages to an even greater extent English language proficiency was the only acculturation factor found to affect whether Iranian elderly utilised health and community aged care services, while ability to engage in activities of daily living (ADL) was the only health variable associated with their utilisation of community supportive aged care services. This variable did not predict the use of community aged care services in the broader sample of NSW respondents. Since limited proficiency in English placed elderly Iranian migrants at greater health risk and impeded their access to necessary assistance, the findings suggest that they would clearly benefit from English classes and from access to health and community care services and information regarding these services in the Farsi language.
10
Edmund, Ampeire. "The utilisation of HIV services on campus by the students of the University of the Western Cape." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7383_1299041199.
Full textAbstract:
This qualitative study was conducted from June to November 2009, using designed questionnaires for sixty three (63) registered students and five (5) HIV program staff .The main reason for this study was to understand the underlying factors for why students may utilize or may not utilize the available HIV services on campus. The willingness of students to express their views was a positive finding in this study. Majority students who answered the questionnaires were quite aware of these HIV services. They also agreed that services provided are good. The study also found out that females utilized these services more than males and majority of students learnt of the HIV services from the HIV programs pamphlets and website thus indicating that the HIV program at UWC is function. However the research study also found out that the though students are aware of these services few utilize them and majority are females thus leaves a question why males do not utilize.
11
Barker, Kimberley. "A grounded theory study of the role of interpersonal processes in community sexual offending group work programmes from a counselling psychology perspective." Thesis, London Metropolitan University, 2015. http://repository.londonmet.ac.uk/1101/.
Full textAbstract:
The effectiveness of Sexual Offending Treatment programmes has generally been measured through evaluating intervention content and reoffending rates. In response to the growing call to explore the role of therapeutic process in facilitating meaningful change on these programmes, this thesis considers how interpersonal dynamics may influence programme effectiveness from the perspective of the group member. This offers the opportunity to consider the impact of how we work, rather than what we do. The critical literature review uses a pluralistic framework to present relevant existing research and identify gaps in practice-based knowledge in the field of sexual offending intervention from a Counselling Psychology perspective. While the literature suggests interpersonal ingredients important to this process, it offers little information regarding where, when and how these qualities are effective. Furthermore, little is understood about the impact of relational dynamics between the facilitators and group members in creating a facilitative environment. This reveals broad gaps in research relating to a neglect of the client’s experience of these interactions and how they are conceptualised in their change process. This research therefore uses a social constructivist grounded theory method to generate data exploring these process issues. The results highlight the value of facilitators fostering a dynamic and balanced core interpersonal process that is sensitive to the unique context of these group interventions. This offers a foundation for group member engagement and effective group functioning relevant to subjective change. The implications for theory and practice are discussed, highlighting how a Counselling Psychology presence in this field has the potential to enhance practice. The study is concluded with reflections of the study’s limitations and areas in need of further research.
12
Bentley, Rosemary Diane. "Dancing with the Shadows of Wellbeing: An Exploration of Participatory Action Research Processes as a Catalyst for Transformation of Staff Wellbeing." The University of Waikato, 2007. http://hdl.handle.net/10289/2505.
Full textAbstract:
My abiding concern with human and planetary wellbeing and an emerging interest in the potential of Participatory Action Research as a method of engaging with restorative, life-enhancing ways of being are central to the research reported here. Chomsky (2003), Kelsey (2002), Roddick (2001), and Stiglitz (2003) are amongst many authors who argue that the way in which we shape and are shaped by our relationships with one another has contributed to an intolerable, inhumane and unsustainable compromise of human and planetary wellbeing. Through a Participatory Action Research (PAR) project with staff from Te Ra, a community based on the holistic ideals of Rudolf Steiner, and thus an organisation explicitly committed to holistic wellbeing of people and planet, we sought to explore the challenges to such wellbeing. While our mutual attention was focused on enhancing staff wellbeing at their place of employment, my wider attention was also given to an investigation of the value of a critical analysis to the wider political and economic context in which this organisation works to meet the aspirations of this community. My deep attention has also focused on the potential for PAR to make a contribution to the transformational aspirations of critical theorists who are concerned to uncover and transform aspects of society that inhibit justice and wellbeing of people and planet. My metaphor of choice, to allow me the engagement in all three spheres simultaneously, is the metaphor of Dance. In my work with the staff of Te Ra, our intent was to 'dance with the Shadows', alluding to Jungian references to hidden aspects of ourselves and this community, to discover if un-wellness and disconnection from self and others could be transformed into flourishing relationships and wellbeing in the organisation. McNiff (2000) proposes that PAR has the potential to generate living theories that redefine the main purpose of organisation theory in terms of human wellbeing. Throughout this research project, principles of PAR are woven in with work of critical organisational theorists, psychologists and anthropologists. The already established ideas of reflection, observation, reflexivity, and action are choreographed with the less often considered ideas of those aspects of the research relationship that may inhibit mutuality. While this organisation is explicitly and deeply committed to underpinning all that is aspired to with a relational ethic, the impact that instrumental practices associated with an intensifying neo-liberal economic external environment have not left this organisation untouched. It took commitment, courage and resources to identify and engage with the Shadows masked by intrinsic and extrinsic pressures and processes that these research participants were experiencing. Engaging in PAR processes allowed us dance 'up close and personal' with their aspirations to begin transforming what was not well, while recognising and reinforcing the organisation's existing strong philosophical and spiritual foundations that emphasized individual freedom and collective responsibility for wellbeing of all. Based on the significant transformations achieved during this project we posit that PAR provides a collaborative opportunity for academics and practitioners to 'dance with the Shadows' of individuals and communities to make a significant contribution to the development of sustainable relationships in workplaces where human and planetary wellbeing is the priority.
13
Williams, Dale, of Western Sydney Hawkesbury University, Faculty of Agriculture and Horticulture, and School of Agriculture and Rural Development. "A participatory approach to evaluating voluntary rural community-based organizations is an effective tool for organizational learning and ensuing rural community development, as evidenced in the participative evaluation of the Southern Riverina Rural Advisory Service." THESIS_FAH_ARD_Williams_D.xml, 1995. http://handle.uws.edu.au:8081/1959.7/69.
Full textAbstract:
The central argument of this thesis is that participative approaches to evaluating voluntary rural community-based organisations are an effective tool for organisational learning and ensuing rural community development. This proposition is explored through the evaluation and strategic planning of the Southern Riverina Rural Advisory Service, a community-based counselling organisation. The Service works with families experiencing financial hardship and associated stress. The thesis is multi-faceted and generic issues included: the importance of commitment by rural communities and organisations to creating frameworks for understanding and acting in integrated ways to the diversity, inter-relatedness and conflict of issues, wishes and needs of members, and to develop the capacity to transform contexts of dependency-oriented crisis situations to ones of self-responsible, interdependent change; the need to view contexts through integration of local, regional, national and global perspectives and to develop networks to integrate understanding and action; and to continue learning how to better enhance organisational and community-based learning.Master of Science (Hons)
14
Lee, Virginia. "From caregiving to bereavement : weaving the strands of identity : a thesis presented in partial fulfillment of the requirements for the degree of Master of Social Work at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1314.
Full textAbstract:
“In what ways does the experience of caregiving for a terminally ill family member affect the experience and process of bereavement?” The identity of family caregivers in palliative care has been ambiguous: caregivers are often unaware they fit the description of ‘carer’. Previous research describes two contrasting constructs that shape the identity of the caregiver: burden and privilege. Research, including this study, suggests that the emergence of identity as a carer impacts on the course and experience of bereavement. Two semi – structured interviews were conducted with a small number of caregiving family members: during the caregiving role and in their subsequent bereavement. This exploratory study used phenomenological research to examine the experiences of those caregivers interviewed. The data were examined using the existential themes uncovered in analysis. This paper reports on those themes.
15
Lee, Susan Kaye. "Alcohol, tobacco and other drug concerns of newly arrived 'CaLD' (culturally and linguistically diverse) women in Perth." Thesis, Curtin University, 2008. http://hdl.handle.net/20.500.11937/1590.
Full textAbstract:
Womens Health Services (WHS) in Perth provides medical services, counselling, information, community talks and workshops, referral, and outreach to women in Western Australia. WHS works with women from over sixty different nationalities, including many newly arrived migrants and refugees. New arrivals access a wide range of WHS programs, but at the time the current study was developed few ethnic women attend the alcohol and other drug (AOD) services offered by the organisation. To address this a needs assessment was conducted with newly arrived women (0 to 5 years in Australia). The needs assessment examined the use of alcohol and other drugs by newly arrived women, the barriers that prevent women from accessing alcohol and other drug (AOD) services and explored the types of services and programs newly arrived women wanted.Method. The needs assessment used both qualitative and quantitative methods. Twenty two service providers working with newly arrived migrant and humanitarian entrant women were either interviewed individually or attended a focus group. The views and experiences of 26 newly arrived women from a variety of culturally and linguistic backgrounds were also collected through one-on-one interviews (n=6) and through focus groups (n=5). The information gathered from these interviews and discussions informed the design of a questionnaire that was administered to 268 newly arrived women. All women participating in the project were 18 years of age or more, Australian citizens, permanent Australian residents or in the process of being granted permanent residency and had lived in Australia 5 years or less.Findings Regarding Tobacco and Alcohol Use. Australian cultural attitudes had had an impact on newly arrived women's alcohol and other drug use. Some impacts were positive, for example, increasing restrictions and the decrease in acceptability of smoking in public places along with strong educational messages about the risk of smoking had influenced some women to quit since coming to Australia. Unfortunately, not all Australian cultural attitudes had a positive impact on newly arrived women. Just under one third of the women (31.7%) who drank alcohol were drinking more alcohol since coming to Australia. Reasons for drinking more alcohol were varied and included alcohol being cheaper in Perth than in their own countries, socialising with Australians who drank alcohol, and using alcohol as a way of coping with stress. However, it is important to note that only a very small percentage of the newly arrived women participating in the needs assessment drank at levels considered risky or high risk for either short term or longer term harm. The vast majority of respondents surveyed did not smoke (n=207; 77.2%) and did not use alcohol (n=201; 76.1%), often due to cultural or religious reasons.Other Results. Other findings of the needs assessment included: • Over 21% of newly arrived women responding to the survey had been put in fear by some one under the influence of alcohol and/ or drugs. Nearly 17% of women responding to the survey had been verbally abused by some one under the influence of alcohol and/ or drugs. • More than one third of the women responding to the survey indicated that they wanted information and support on family violence. • Over 40% of the women responding to the survey wanted information and support for depression. • Forty women (14.9%) responding to the survey wanted support for husbands or children that were drinking too much alcohol.A surprising finding was the high level of interest in women's only exercise classes and opportunities to participate in other types of physical activity Two thirds of questionnaire respondents said that exercise was a priority for them. Subsequent feedback sessions with newly arrived women about the results of the needs assessment confirmed the need for opportunities to participate in a variety of physical activities in a safe, affordable, women only environment where childcare was available.Understandings of Alcohol and Other Drug Services. Participants in the study appeared to have a poor understanding of what AOD services were, different types of treatments and models that could be used, who was entitled to access them (not just the alcohol or other drug user), the associated costs and fees, and whether or not the police would become involved. There was a significant lack of understanding by service providers working with newly arrived women about eligibility to access alcohol and drug services and what assistance and support these agencies could provide either to women using alcohol and other drugs or to family and friends impacted by another's drug use. Few service providers asked their clients any questions about alcohol or other drug use on a regular basis.The findings from the needs assessment have been used to improve programs and services with newly arrived women at WHS. These have included the addition of a specific alcohol and other drugs program for women from culturally and linguistically diverse backgrounds with a focus on prevention activities as well as opportunities for newly arrived women to participate in a variety of physical activity classes.
16
Wellstead, Peta Veronica. "The help seeking behaviour of Australian men during stressful life events: an exploration of information exchange relationships." Thesis, Curtin University, 2009. http://hdl.handle.net/20.500.11937/2034.
Full textAbstract:
In recognition of the particular issues related to health and wellbeing considerable government and community resources have been forthcoming in recent times for the development of information products and support services to assist members of the community to seek help for issues related to their health and wellbeing. Notwithstanding this investment, research from studies into help seeking by Australian men shows that men are not aware of these information products and services have difficulty mobilising help during periods of physical ill health and mental stress. Men are over reported in the statistics for premature death in Australia and male suicide is a significant public health issue in Australia. Aspects of Australian culture may lead to increased risk of poor health, harming behaviours and suicide in Australian men. Social norms may also impact on low levels of voluntary help seeking by Australian men.At the core of this research is an examination of the information seeking behaviour of a group of Australian men who engaged in help-seeking during a significant, and stressful, life event. The research also canvassed the opinions of this group of men and a group of professionals who offer help and support to men during stressful life events for their opinions on effective strategies to engage men about the worth of early help seeking to enhance physical and mental health.This thesis also examines a range of existing models which seek to explain human information behaviour and the variety of ways which individuals access and use information in a range of contexts. It explores how these models can increase understanding of men’s information seeking for personal decision making and personal change. Research which provides data on the possible protective role of healthy emotional attachment systems, together with the role of social and emotional support across the life span, and the information delivery capacity of this support, is also examined.The research leads to recommendations for enhanced social policy to support men’s information needs during periods of life stress. It also makes recommendations for enhanced praxis in order that information practitioners, and the agencies in which they work, may better engage with men with information products and support systems which will lead to increased personal wellbeing for men and their families.
17
Gakunde, Yves P. "The potential role of payment for ecosystem services in protected area management in Rwanda: A case study from Gishwati-Mukura national park." Antioch University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1597951038532134.
Full text
18
Hough, Christine Victoria. "Every child matters : a small scale enquiry into policy and practice." Thesis, University of Cumbria, 2010. http://insight.cumbria.ac.uk/id/eprint/3736/.
Full textAbstract:
1. This research study examines aspects of the effectiveness of the Every ChildlYouth Matters (ECMIYM) programme with regard to its implementation in 2006. Part 1 of the study explores the practical implications of ECM/YM for professional practice across the different welfare agencies, through a series of loosely structured interviews with managers, case workers and young offenders (aged up to 16 years). From an analysis of the data, using grounded theory approaches, three key findings were inducted. These findings suggested the following: I. A lack of consistency in the quality of targeted support provided by integrated services for the most vulnerable children and young people and their families; II. A lack of fine tuning in: a) the identification of vulnerability across different cohorts of children and young people, according to their changing circumstances; b) the ways in which information (about vulnerable children and young people) is shared and used across the different welfare agencies. 2. Reflection on these findings led to a further review of the literature that focuses on critiques of social policy. The analyses of research data within this domain suggest the limitations of social policy making that conforms to a linear, mechanistic approach, because it does not respond to individualised, local need. This suggests further that it is the policies themselves that account for the perceived lack of fine tuning identified in the above findings in part one of this research thesis. Therefore it was important, next, to capture data which drew on respondents' personal perceptions of welfare provision, which might endorse, or otherwise, those aspects in which part 1 of the study suggested that the ECM/YM agenda is failing, in some localities, to meet the needs of the most vulnerable children, young people and their families. 3. In part two of this study, further research was conducted through a series , of extended conversations with: male offenders (aged between 16 and 24 years); parents/partners of prisoners; managers from voluntary/not for profit organisations and senior multi-agency professionals. The data were analysed using a phenomenological approach. Overall, the findings suggest that a purely mechanistic, evidenced-based approach to providing welfare support for vulnerable children, young people and their families can result in negative outcomes when compared with a more contextualised, holistic approach.
19
Schooneveldt, Simon P. "Do the lived experiences of people who have been breached by Centrelink match the expectation and intent of the Howard Government?" Thesis, Queensland University of Technology, 2002. https://eprints.qut.edu.au/85/1/schooneveldtThesis.PDF.
Full textAbstract:
In the past three years, the number of breach penalties applied by Centrelink to welfare recipients have more than trebled, with some 349,000 incidences reported for the 2000-2001 year. This Masters Degree research study examines the lived experience of some individuals who have been breached by Centrelink, to ascertain whether their lived experiences accord with the stated policy expectations and intent of the Howard Government. Government policy statements are identified from the literature, as are a range of alternative viewpoints and critiques offered by commentators.
A qualitative research survey instrument was developed. Survey data was collected from people passing on the footpath outside three Brisbane Centrelink offices. Fifty-six individuals who stated they had been breached at least once responded. The results of primary and secondary analysis of the collected data is presented in the findings, followed by discussion as to how the lived experiences of the unemployed respondents matched Government expectation and intent
20
(9779711), Annerley Bates. "Female graduates developing sustainable professional practice in the field of statutory child protection." Thesis, 2013. https://figshare.com/articles/thesis/Female_graduates_developing_sustainable_professional_practice_in_the_field_of_statutory_child_protection/13461887.
Full textAbstract:
"In response to the issue of recruitment and retention of statutory child protection workers, this research focuses on the ‘professional practice’ of frontline child protection workers and investigates how graduates transition into and develop sustainable professional practice in their first 12 months of work."--p. 1.
21
(9839195), Davina Taylor. "Stories from the frontline: Policy, practice and the experiences of disability support workers." Thesis, 2020. https://figshare.com/articles/thesis/Stories_from_the_frontline_Policy_practice_and_the_experiences_of_disability_support_workers/14622906.
Full textAbstract:
This research explored the experiences of Disability Support Workers (DSWs) supporting people with intellectual disability in supported accommodation in Queensland, Australia. The research also looked at how the experiences and practice of DSWs are influenced by contemporary philosophies and policy. The research was underpinned by social
constructivist grounded theory and utilised semi-structured in-depth interviews with ten DSWs. Using constant comparison, three key categories emerged from the data: ‘Self’, ‘Clients’ and ‘Organisations’. ‘Self’ refers to how DSWs feel about the work they do and how
their role impacts them in personal ways. The codes associated with ‘Self’ are ‘No better job’,
‘Trapped’, ‘Shift work, Work stress, Burnout’ and ‘Self-care’. The category of ‘Clients’ represents the DSWs experience with the people they support and includes ‘Perceptions of clients’, ‘Supporting clients’ and ‘Challenging behaviour’. The final code, ‘Organisations’, described the DSW experiences from an organisational perspective and includes the codes
‘Administration’, ‘Training’, ‘Management’, ‘Casualisation’ and ‘Colleagues’. The findings show that while every DSW participant was working in similar roles with the same overarching legislation and current disability policy and philosophies, their experiences were all very different. In addition to this, DSWs spoke of their employers coming from a different
reality; for example, the need for DSWs to attend compulsory training when the DSWs do not find it relevant to their role or the dichotomy of needing to provide duty of care and client choice and control. Two realities was established as a substantive theory to describe the
DSW experience working with people with intellectual disability in supported accommodation in Queensland, Australia. The substantive theory of two realities encapsulates the observation that while every DSW participant was working in similar roles with the same overarching legislation and current disability policy and philosophies, their experiences were all very different. The finding of two realities has significant implications on practice as this finding provides evidence that the experiences of DSWs are remarkably different, which means that DSWs provide varying levels of support to people with intellectual disability. Two realities highlights the issue that what is written as process and procedure is not always what happens in practice
22
(375038), Christine Johnston. "Abused and pregnant in the country: Implications for rural midwives." Thesis, 1999. https://figshare.com/articles/thesis/Abused_and_pregnant_in_the_country_Implications_for_rural_midwives/19930133.
Full textAbstract:
A descriptive study was conducted to assess the percentage of domestic violence amongst the pregnant women of a small country town in Queensland. It identified the types of abuse categorised as physical, sexual and psychosocial which women experienced during their pregnancy. The study determined the relationships and the effects of rurality on the abused women's life situation.
A sample of 91 women completed a self -report questionnaire between August and November 1998. The questionnaire was adapted from three abuse assessment sheets used in other studies (Helton, 1987; King, Torres, Campbell, Ryan, Ulrich & McKenna, 1993; Webster, Sweet & Stolz, 1994). The questionnaire was tested for validity during a pilot study.
Data was analysed using descriptive statistics. The Epistat 6 program was used for conducting a Chi-square test with Yates Correction in order to test relationships between two or more variables.
The results showed that 12 per cent (n=11) of women experienced abuse. Of those 12 percent all were abused prior to their pregnancy and for some the abuse
continued in pregnancy. Pregnancy is a risk factor for abuse and the assessment of abuse in pregnancy needs to be included as part of the antenatal interview.
23
(9819311), Joanna Mensinga. "My Body/Mind tells me things my profession and sometimes I find hard to hear: A narrative exploration of how social workers and human service workers listen to their bodies in practice." Thesis, 2017. https://figshare.com/articles/thesis/My_Body_Mind_tells_me_things_my_profession_and_sometimes_I_find_hard_to_hear_A_narrative_exploration_of_how_social_workers_and_human_service_workers_listen_to_their_bodies_in_practice/13443617.
Full textAbstract:
The role and impact of the body in professional practice has attracted increased attention in recent years (Green & Hopwood, 2015a; Hopwood, 2015), however it has not received the same level of interest in social work. Although social work and human service practitioners have long understood the importance of placing the body in particular positions to reduce power imbalances between worker and client and to facilitate constructive conversations, how body processes (including neurobiological activity) impact the quality of assessments and interventions have not been much explored nor considered important (Cameron & McDermott, 2007). Similarly, even though embodied practices such as yoga have increased in popularity and gained credibility as a therapeutic approach (Chan, Ng, Ho, & Chow, 2006; Emerson, Sharma, Chaudhry, & Turner, 2009), little exists to encourage and/or assist social work and human service practitioners to move beyond the dualistic underpinnings of the professions or to explore alternate ontological and epistemological ways of being and knowing and what they may offer clients and/or their own understanding of practice.
This research project, using a narrative inquiry approach underpinned by a post-conventional philosophical base (Bell, 2012), provides a rich description of how three social workers and three human services practitioners constitute and narrate an embodied professional self as they navigate the professional contexts in which they work. The stories told by these participants reveal that, in response to the dominance of Cartesian Dualism and its influence on cultural and professional understandings, the processes they use to constitute an embodied professional self is largely a private undertaking that remains ‘secret’, unacknowledged, misunderstood and/or discouraged in the workplace and supervision context. Moreover, the decision to story themselves as an embodied ii
professional self is a political act influenced by participants’ perception of whether the embodied self will contribute to their professional positioning, ‘moral agency’ and/or ability to secure outcomes for clients in the sector (Healy, 2014; Lindemann-Nelson, 2001).
24
(9818855), Jacqueline McNamara. "An exploration of social workers’ professional identities within health settings in Queensland." Thesis, 2018. https://figshare.com/articles/thesis/An_exploration_of_social_workers_professional_identities_within_health_settings_in_Queensland/13445804.
Full textAbstract:
Social workers make up a significant number of the professionals and are key members of multidisciplinary teams employed within the health sector in Queensland. Shifting government priorities such as increased governance, managerialism, privatisation and marketisation of the health sector in Queensland are consistently shaping health service delivery. These are subsequently reflected in the delivery of social work services in this context. This has prompted an exploration of how social workers develop and maintain their professional identity when working amidst the presence of medical dominance and evolving neoliberal ideology that underpin the operation of health services within Queensland.
25
Desai, Aasya B. I. "Counselling community counsellors for survivors of violence in Mandeni, KwaZulu Natal." Thesis, 2001. http://hdl.handle.net/10530/658.
Full textAbstract:
A dissertation submitted in partial fulfilment of the requirements for the degree of Master of Arts in Clinical Psychology in the Department of Psychology at the University of Zululand, 2001.Sporadic violence, both politically and criminally related, has led to KwaZulu-Natal being labeled the most volatile region in South Africa. The Human Science Research Council, in a nationwide survey conducted in 1994, found that one in four South Africans has been a direct or indirect victim of crime. The urban areas offer a multiplicity of lay counseling services' to victims of violence; however, the availability of basic counseling services is almost non-existent in many far-reaching rural areas. Factors such as poverty, the subsequent non-availability of transport and telephonic linkage disadvantages the rural inhabitants even further. The University of Zululand, a founder member of the Zululand Community Mental Health Programme, has initiated various community projects in and around northern KwaZulu-Natal. As part of the University of Zululand's Community Psychology Project, the Psychology Department has been actively involved in various community outreach programmes in northern KwaZulu-Natal, including the Mandeni region. From a series of meetings organised by the Mandeni Transitional Council that comprised representatives of the local community, it emerged that there was a dire need to equip laypersons with basic counselling skills. It was decided by these representatives (who comprised people from all professional spheres including members of the police force and nurses from the surrounding clinics and hospital) that police personnel and nurses were most often the first line of contact for victims of violence. However, these individuals themselves felt that they were ill equipped to counsel victims of violence. An appeal was thus made to the University of Zululand's Psychology Department to assist in training these first-line contacts who deal with victims of violence on a daily basis. The aim of this research was to use phenomenological explication to determine the nurses' and police personnel's experiences of dealing with victims of violence and, extending from this, to tailor a lay counselling programme that will benefit the community. Whilst the evaluation of lay counsellors' performances indicated a reasonable success in equipping them with basic counselling skills, an interesting extension of these findings portray a degree of resistance exhibited by select rural male lay counsellors. This could indeed provide an impetus for further research in the area of training rural male counsellors.
Centre for Science Development
26
Roberson, Peter. "The role of spirituality in the wellbeing of community health care workers at Temba Community Development Services." Diss., 2016. http://hdl.handle.net/10500/22207.
Full textAbstract:
The research focused on employee wellness and explored and described the role of spirituality
in the wellbeing of CHCWs of HIV/AIDS patients. It was important to determine how CHCWs
dealt with the stress of caregiving, due to the increasing number of HIV infections and burden
on government resources. The approach was a phenomenological qualitative study using faceto-
face interviews to collect data from a purposive sample of eight CHCWs from a population
of 250 at Temba. The audio-recorded interviews were transcribed verbatim and analysed for
emerging themes using thematic analyses. The research findings provided evidence that
spirituality impacted positively on the wellbeing of the CHCWs by providing the coping
mechanism to deal with stress. The conclusions drawn were that personal and organisational
wellbeing operated at an optimal level due to the influence of spirituality.
Recommendations were that formalised spiritual programmes were offered as a tool to equip
CHCWs in their duties.Industrial and Organisational Psychology
M. Com.
27
Senior, Kate Adèle. "A Gudbala Laif? : health and wellbeing in a remote Aboriginal community - what are the problems and where lies responsibility?" Phd thesis, 2003. http://hdl.handle.net/1885/109708.
Full textAbstract:
The the sis is a study of a single community, its health, expectations and
aspirations. It is a study of understand in g and responsibility in the
context of dependence. The primarily ethnographic work for this thesis
was undertaken in Ngukurr over thirteen months between 1999 and
2002. Ngukurr is a remote town on the south east border of Arnhem Land in
Australia’s Northern Territory. Its long term residents are Aboriginal
people. The thesis presented here examines these people’s
understanding of health and illness in their community and their
attainment of a good life. My study focuses on issues around people’s
engagement with and disengagement from, the management of their
health and health service delivery.
My thesis is guided by the following questions:
• how do people assess their health status?
• how a republic health services perceived?
• what expectations does the community have about the type and
quality of the services provided ?
• do people seek an active role in the management of their
health ?
People’s attitudes to and expectations for their health are examined in
the context of a history of direct welfare dependence till the mid nineteen
seventies; followed by local self government in which fiscal and
administrative responsibility were held by Government or outside
individuals. The evidence for health status, morbidity, and mortality among the
remote indigenous population is significantly worse than non indigenous
Australians and h a s been the subject of extensive Commonwealth and
State health programs to little obvious effect.
The literature I survey shows that people in poor communities rate their
health more highly than the objective data suggests. Ngukurr residents
rate their health in a similar way, b u t their apparent satisfaction masks
complex beliefs about illness and concerns about health.
I demonstrate that the community believes that outside influences are
more important than personal actions as a cause of poor health, that
there is little respect for the community’s view of health or health
services, and in consequence there is little point in taking personal or
collective responsibility.
Ngukurr residents are not disinterested in health. They are acutely
aware of the patterns of morbidity and mortality in their community and
consider these to have a negative impact on their quality of life. Their
ability to bring about changes in these patterns is limited by different
paradigms of health and illness which sometimes appear as fatalism,
powerlessness in the non-Aboriginal domain, loss of confidence due to
poor communication with non indigenous providers, and consequent low
expectations with regard to personal and community health.
This creates a challenge for current policies to devolve management
responsibility for health services to local communities. Policy makers
should make considerable efforts to u n d e rs tan d local health beliefs and
value systems and ensure that changes are appropriate, rather than
making changes in health systems based on non-indigenous
understandings of needs.
28
Edmund, Ampeire. "The utilization of HIV services on campus by the students of the University of the Western Cape." Thesis, 2009. http://hdl.handle.net/11394/3723.
Full textAbstract:
Masters of ScienceThe origin of HIV/AIDS has puzzled scientists ever since the illness first became known in the early 1980s. It is now over twenty years down the line, still the pandemic is the subject of fierce debate and the leading cause of death in the world with sub-Saharan Africa being the worst hit region. With almost everything put in place in 21st century, the rates of infection continues to rise, thus this study tries to find out the undermining factors for full utilization of HIV services in higher institutions of learning,particularly the University of the Western Cape.The services are; free HIV testing and counseling, free medication; provision of free condoms to the students in their halls of residences, peer education programs, and making them easy to access, and prevention of mother to child transmissions.This qualitative study was conducted from June to November 2009, using designed questionnaires for sixty three (63) registered students and five (5) HIV program staff .The main reason for this study was to understand the underlying factors for why students may utilize or may not utilize the available HIV services on campus. The willingness of students to express their views was a positive finding in this study. Majority students who answered the questionnaires were quite aware of these HIV services. They also agreed that services provided are good. The study also found out that females utilized these services more than males and majority of students learnt of the HIV services from the HIV programs pamphlets and website thus indicating that the HIV program at UWC is function. However the research study also found out that the though students are aware of these services few utilize them and majority are females thus leaves a question why males do not utilize.
29
Lindsay-Smith, Gabrielle. "Active Ageing in The Community. Exploring the Role of Community Activity Groups for Older Adults for Physical Activity, Health and Wellbeing." Thesis, 2019. https://vuir.vu.edu.au/40057/.
Full textAbstract:
The proportion of older adults (60+ years) globally, is predicted to more than double between
2017 and 2050. Ageing is often associated with declining health and physical capacity, but
has the potential to be a positive experience, often termed Active Ageing or successful
ageing. The promotion of Active Ageing within the community, is important, to ensure
positive experiences of older adults, and to lessen the burden that older adults have on health
and social services. Physical activity (PA) and social support are key determinants of Active
Ageing, however, PA declines with age.
The aim of this PhD was to investigate Active Ageing in the community, through
participation in volunteer-run community activity PA and social programs. This research
adopted a case-study approach, specifically the community organisation and associated
activities, was Life Activities Clubs Victoria (LACVI). This research included two systematic
reviews (study 1), a longitudinal self-report quantitative survey study (n=35, mean age=67)
administered in three waves (baseline, six and twelve months) analysed using linear mixed
models, and four focus groups (n=24) which were analysed using thematic analysis. A
mixed-methods study synthesising results from the survey study and two focus groups (n=11)
explored the impact of participation in social and PA programs on social wellbeing, PA and
health (study 2a and b). The final qualitative study, analysed the four focus groups, including
participants from LACVI and other community activity programs (e.g. Men’s Shed). This
study explored how and why participation in PA and social programs impact wellbeing.
Study 1. The systematic reviews investigated the association between social support or social
integration and PA. In summary, social support for PA and social integration factors, having
large friendship networks, and connecting widely and regularly with people, were positively
associated with PA levels.
Study 2 a and b. Synthesis of the findings of the mixed methods study suggested that
program participation significantly reduced loneliness. In addition, participants felt they
gained social connectedness through program participation and this was especially important
at times of significant life events. The studies suggested that socially oriented PA programs
increased motivation to adhere to PA programs long term. This was supported by
maintenance of PA levels over one year in the PA groups compared to reduction over one
year in social group participants.
Study 3. The final qualitative study utilised a leisure-based model of wellbeing to explore the
aspects of program participation that older adults felt were important for their wellbeing. in
summary, older adults appreciated groups that they could identify with, in order to develop
new social contacts, with activities that gave them control, enjoyment, meaning and challenge
in their lives. The analysis suggested that both social and PA programs could provide these.
Overall, this program of research suggests that community activity programs for older adults
offer a variety of benefits for older adults and thereby promote Active Ageing, especially
when a variety of types of activity are offered in one setting, with a social focus and in a way
that older adults feel they can relate to.
30
Arumugam, V. "Evaluation of the Wits crisis centre lay counselling training course via trainee perceptions." Thesis, 2016. http://hdl.handle.net/10539/21349.
Full textAbstract:
Abstract
Keywords:
Lay counsellors, training and evaluation.
The training of lay counselling is of great significance to the field
of Counselling Psychology. Therefore,the Health Professions
Council of South Africa (HPCSA) decided to allow for the registration
of lay counsellor training courses. However, the criteria for registration
need to be formulated. This study evaluated the Wits Crisis course
for volunteer counsellors, via illumination of the perceptions of the trainees and a measurement of their self-efficacy and personal relations before and after the training. The study included qualitative
and quantitative methodology. Past trained counsellors and trainees
were interviewed and then assessed on Self-Efficacy and Personal
Relations before and after training. A Wilcoxon Matched-Pairs Signed-Rank significance in self-efficacy or personal relations scores
after training. However, the interviews of the participants' perceptions
of the course and its impact on them supported the hypotheses. Overall, perceptions were positive. Negative perceptions were highlighted, as this information could add to the knowledge base of the program.GR 2016
31
(8800841), Kristina N. Fairbanks. "Comfort Communicating Constructs on Relationship and Sexual Satisfaction." Thesis, 2020.
Find full textAbstract:
Research shows the significance that communication patterns, beliefs, and behaviors hold within a multitude of relationship types. Unfortunately, the same research also shows that effective or positive communication is still not occurring as often as we think. Communicative interaction breaks down, fails, or is utilized negatively more often when emotionally charged topics are at the forefront of the conversation, most often due to reported personal discomfort. This negative interaction, and the subsequent breakdown in communication, can foster a snowball effect – decreasing relationship and sexual satisfaction. This study was aimed to discover how perceived comfort levels contributes to the lack of communication of certain topics and how it is affecting relationship and sexual satisfaction. The type of communicative process that occurs will affect the sexual satisfaction and relationship satisfaction. Through an online survey, participants anonymously responded to statements related to these concepts in order to test relationships. Overall, it was found that respondents’ participation in self-monitoring, as well as what method of communication they use, strongly influenced their comfort disclosing on different topics. Their comfort did not have significant influence on their then communication process. It was also found that communication processes influence couple’s relationship and sexual satisfaction. These results urge marriage and family therapists to update their clinical toolboxes and add self-monitoring to their conceptualization when working with couples.
32
(8083058), Rachael E. Martin. "Impact of Parent Trauma on Parents' Beliefs Regarding the Benefit of Child Mental Health Care Services." Thesis, 2019.
Find full textAbstract:
The purpose of this quantitative study was to examine
the interaction between parents’ own trauma and their assessment of their
child’s functioning and its relationship to the parent’s belief that their
child would benefit from mental health care services. The parents’ trauma
experience was measured using the Adverse Childhood Experiences (ACEs)
questionnaire and Trauma History Questionnaire (THQ), and the child’s
functioning was measured using the Columbia Impairment Scale (CIS). It was
hypothesized that the higher number of traumas a parent experienced was
associated with a weaker relationship between a parent’s assessment of their
child’s functional impairment and the likelihood a parent recognizes the
benefit of mental health care services for their child. One hundred and
eighty-four people participated in this study. Data were analyzed using
multiple binary logistic regression, and no significant relationship was found
between a parent’s assessment of their child’s functional impairment and that
parent’s belief that their child would benefit from mental healthcare services.
The parent’s childhood THQ score and age were found to have significant
positive relationships with the parent’s belief that their child would benefit
from mental healthcare services. The variable found to have the most
significant positive relationship with the parent’s belief that their child
would benefit from mental healthcare services was an educational or healthcare
professional telling the parent that the child would benefit from mental health
care services. Clinical implications, limitations, and future directions for
research were addressed.
33
Staniforth, Barbara Lynn. "Past, present and future perspectives on the role of counselling in social work in Aotearoa New Zealand : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Work at Massey University, Auckland, New Zealand." 2010. http://hdl.handle.net/10179/1276.
Full textAbstract:
Since the profession of social work began, there has been debate about whether it should be involved in helping individuals make change, or in encouraging societal change. Towards gaining an understanding of how this debate has played out in Aotearoa New Zealand, this research explores the question “What are the past present and future perspectives on the role of counselling in social work in Aotearoa New Zealand?” A mixed methodology format was used in this research. Qualitative interviews with individuals who had helped create the professions of social work, counselling and psychology were conducted to help understand the historical development of counselling within social work, and the factors which had impacted upon it. Questionnaires were then sent out to 985 members of the Aotearoa New Zealand Association of Social Workers that asked about members’ current views on, and practice of, counselling within social work. The research shows that social work developed late in New Zealand within a welfare state where governments questioned the need for it. With social work education not widely available until the 1970s there was limited training in counselling type approaches. The drive for professionalism (often aligned with those doing counselling) was tempered by those mindful of community and bicultural commitments due to differing ideologies and lack of access to education. Tangata whenua have had a major impact on the development of social work, and counselling within it. Respondents in this research were clear that aspects of counselling fell within their definitions of social work and that counselling in Aotearoa New Zealand should hold a strengths-based, collaborative stance that recognised the importance of a bicultural perspective. Most respondents indicated that they did some amount of counselling within their practice, but only 34% of respondents felt that their basic social work qualification had prepared them adequately or really well for their counselling role. The majority of questionnaire respondents had undertaken additional training to help them with their counselling role and over two-thirds indicated a strong desire to engage in further study in counselling. Registration of the helping professions presents challenges that include the potential for unhelpful competition between them. The thesis concludes that there is a need for more counselling education options for social workers and that there is a need for the profession of social work to formally define its scopes of practice.
34
(8781260), Briana N. Walker. "Societal Influences on Relationship Satisfaction in Black-White Interracial Couples." Thesis, 2020.
Find full textAbstract:
Interracial couples
have different experiences compared to their intraracial counterparts. Interracial
couples and their relationships (particularly their marriages) have been
studied to see whether there are any effects on the relationship due to the
couple’s inherent differences. However, the literature heavily focuses on
interracial marriages while only touching on interracial relationships in
general, with a primary focus on interracial couples of all kinds. With the
tension between White and Black Americans over the years, one can wonder if
there would be any noticeable differences within Black/White interracial
couples with regard to racial identification and experienced discrimination due
to the Black-White racial disparity. This study tested whether these factors
contribute to the overall relationship satisfaction in Black/White interracial
couples. Data were collected via MTurk and participants completed three
assessments to capture how racial identity and experienced discrimination
impact their relationship. Racial identity was assessed using Worrell, Mendoza,
and Wang’s (2019) Cross Ethnic-racial Identity Scale- Adult (CERIS-A);
perceived racial discrimination was assessed Conger’s (2006) revised version of
Landrine et al.’s (2006) General Ethnic Discrimination Scale; and relationship
satisfaction was assessed using Funk and Rogge’s (2007) Couples Satisfaction
Index (CSI-16). It was predicted that experienced discrimination and racial
identity would impact the relationship satisfaction of Black-White interracial
couples. The results showed that experienced discrimination did significantly
impact relationship satisfaction and racial identity, however, racial identity
did not significantly impact relationship satisfaction in Black-White interracial
couples. The lack of research on the CERIS-A’s validity when interacting with
other constructs, a missing question on the CSI-16, and not accounting for
biracial participants and their experiences with racial identity development
are all limitations that should be considered when reviewing the results. Clinicians
can use the information from this study to assist clients in having more
conversations about their experiences of discrimination with one another and
having them create their own meanings around interracial dating and racial
identity.
35
Harris, Mary. "A hermeneutic investigation of the influences on and perceptions of breastfeeding and mother-child bonding from the perspectives of survivors of child abuse." 2008. http://arrow.unisa.edu.au/vital/access/manager/Repository/unisa:38417.
Full textAbstract:
This research investigated an issue that has implications for early breastfeeding cessation and impaired mother-child bonding. It focused on child abuse survivors' perceptions and reactions surrounding breastfeeding and bonding, the necessity of trust before disclosing abuse, and the transition to self-efficacy. It also provided recommendations for health professionals' practice.
36
Yu, Nilan G. "Managing competing mandates : social work in Philippine municipalities." 2005. http://arrow.unisa.edu.au:8081/1959.8/46349.
Full textAbstract:
This study set out to answer the question: In what ways do social work practitioners in Philippine municipalities manage competing mandates? The research question was informed by a number of theoretical propositions outlined in Chapter 1 and a particular construction of social work as described in Chapter 2. The approach taken was to ground the study in a particular practice setting, with the study participants being social workers serving as Municipal Social Welfare and Development (MSWD) Officers in Philippine municipalities.
37
Hanna, Sue. "Breaking another silence : the long-term impacts of child sexual abuse on committed lesbian couples : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Work at Massey University, Auckland, New Zealand." 2005. http://hdl.handle.net/10179/1552.
Full textAbstract:
This qualitative research enquiry sought to develop an understanding from forty-four women, comprising twenty-two couples in committed lesbian partnerships, of how they managed the long-term impacts of child sexual abuse, both on themselves and on their relationships. This is an area that is under- theorised in the literature. A number of key findings emerged from the analysis. The sexual abuse that women had experienced had impacted their adult lives in various ways. Of these the personal aspect featured most highly, with feelings of self-blame, shame and low self esteem commonly reported. Those women who reported physically invasive sexual abuse also reported a wider variety of effects, and in proportionately greater numbers, than women whose abusive experience had not encompassed that particular dimension. Just as the survivors were impacted in a variety of ways by their abuse, so too were their partners, although the effects upon the partner varied over time and in intensity depending on the length of the relationship and the degree of resolution experienced by the survivor. Despite challenges the over all view of couple relationships was positive, and couples were able to articulate coping strategies they felt would be useful to others in similar circumstances. Partners were able to identify with many of the relationship issues outlined by heterosexual male partners of female survivors, although lesbian partners had more a positive view of counselling. The emotional support and commitment of a caring partner was clearly valued although in these partnerships both women wanted their relationship to be based on more than the reparative needs of one member. Finally, being lesbian was no barrier to seeking counselling assistance. A large proportion of the participants had used counselling as a way of working through their experiences of child sexual abuse and had found this to be valuable. These findings have implications for social work practice with child and adult female survivors. They emphasise the long term impacts of sexual abuse, the important contributions made by partners and counsellors in supporting women sexually abused as children and the levels of inter-sibling sexual abuse perpetrated by brothers. The research findings also contain information from the women themselves on what facilitated their ability to cope with the effects of child sexual abuse from the varying perspectives of survivor, partner and couple. This will be essential information for counsellors and social workers wishing to employ strengths and evidence-based approaches in their work with this client group and others, particularly heterosexual women and heterosexual couples.
38
(6630641), Mackenzie M. Sullivan. "The Role of Differentiation of Self and Gender on the Experience of Psychological Aggression by a Romantic Partner." Thesis, 2019.
Find full textAbstract:
The study aimed to understand and advance the dynamics that influence psychological aggression. Psychological aggression can be defined as, verbal and non-verbal communication with the intent to harm another person mentally or emotionally, and/or control another person. In our society, the occurrence of psychological aggression in relationships is far more tolerated then physical aggression, but the effects can be more long term and harmful. The study hypothesized that an individual’s level of differentiation of self--a person’s ability to differentiate between feeling and thinking in times of stress--and their gender have a role in the severity of psychological aggression. The study was approved by IRB and using an online survey through MTurk asked participants about experiencing and perpetrating psychological aggression in their romantic relationships. The study had 192 participates in the multiple regression analyses, who provided some support that the level of differentiation of self and severity of psychological aggression, experiencing and perpetrating, have a negative significant relationship. Gender was found to not impact the relationship between differentiation of self and severity of psychological aggression. Clinical implications, limitations, and future directions for research were addressed.
39
Field, Adrian. "Pathways and policy : approaches to community resource access, health and wellbeing in two New Zealand cities : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Centre for Social and Health Outcomes Research and Evaluation, Massey University, Albany, New Zealand." 2004. http://hdl.handle.net/10179/1692.
Full textAbstract:
This research examines access to community resources - services, facilities and amenities that are potentially health promoting - in two New Zealand territorial authorities, and the policy and planning frameworks of each regarding community resources. International research evidence indicates that community resource access is potentially beneficial to health and wellbeing, through creating supportive environments for health, and providing venues to facilitate social connections. Review of the urban design and planning literature indicates that community resource access is strongly influenced by the dominant urban design and planning models. Geographic information systems were used to develop a Census meshblock-based indicator of community resource accessibility (the Community Resource Accessibility Index). Quantitative analysis examined associations of resource access with socio-economic and demographic population patterns. Qualitative analysis, using key informant interviews and document analysis, explored policies on community resource access, and the role of health and wellbeing as a policy goal for each territorial authority. Quantitative analysis revealed the socio-economically wealthier city had higher overall levels of community resource access, but within each city, more deprived areas had higher levels of access. The location of community resources within poorer areas reduces the mobility costs of people within these areas to access such resources, and makes more available the general health benefits of community resources. Qualitative analysis indicated community resources are important components of urban strategies. Historic patterns of community resource development, aggregated city wealth and local policies were important determinants of the level of community resource access. In New Zealand, as will be the case internationally to varying degrees, there is considerable scope for territorial authorities to enhance local health and wellbeing, through direct delivery of community resources, and through collaboration with external agencies to develop community resources that are outside the direct responsibilities of territorial authorities. When these findings are considered in the context of the passage of local government legislation in late 2002, there is growing potential for territorial authorities to use a variety of levers to enhance community resource access, and by implication, health and wellbeing. Health promoters have opportunities to engage with local government and contribute to urban development strategies, for the purposes of enhancing population health and reducing health inequalities.
40
Martin, Sonia. "Social divisions in an era of welfare reform: a critical analysis of neoliberalism and the underclass thesis." 2006. http://arrow.unisa.edu.au:8081/1959.8/28285.
Full textAbstract:
This thesis is a study of social divisions and an assessment of the impact of neoliberalism upon them. Its purpose is to investigate the nature of contemporary social divisions, and whether or not the ????underclass???? is a useful way of conceiving the social and economic marginalisation of some individuals. The underclass thesis crystallises in a powerful and contentious way some fundamental premises that underpin the neoliberal philosophy, namely that the welfare state is considered a threat to freedom, discourages work, and is socially and economically damaging. Thus there ought to be a reduced role for the state in the provision of welfare. There are two fundamental weaknesses in social democratic critics???? contributions to debates about welfare reform. The first relates to a focus on residual welfare and measurements of poverty, largely neglecting the systems of power that underlie welfare distribution. The second relates to the omission of agency. Critics???? responses have tended to ignore the behaviour of the welfare beneficiaries targeted by current reform. In order to address both of these issues, I have formulated a critical post-traditional paradigm of social divisions. The study comprises three stages. The first is an historical overview of neoliberal policy developments and a quantitative analysis of social divisions. The findings indicate that neoliberal nations have the lowest commitment to welfare, and the highest levels of poverty and widening inequality. In Australia, labour market changes and educational underachievement are likely to contribute to new and emerging divisions, and the cumulative nature of disadvantage is apparent within low socio-economic areas. The second stage of the study examines the policies of the Howard Coalition Government in Australia and focuses on the prevalence of the underclass phenomenon in current welfare reform. Records central to the Government????s welfare reform agenda are analysed to examine policy makers???? normative beliefs. The findings reveal that the underclass thesis is an ideological construct that legitimises a reduction of welfare provision and control of the unemployed. The third stage of the study focuses on the experiences of unemployment among young people, and the views and experiences of welfare providers who work with them. The data show that individuals make decisions about their lives from the range of options they perceive to be available to them at a particular point in time. These options are not limited to those made available by the provisions of the welfare state, nor are they solely the product of inter-generational welfare. The welfare providers enforce the Government????s position on welfare reform by endorsing a version of the underclass thesis in their work and directing their interventions at the individual. Considered together, the findings reveal that a conservative neoliberal social policy fails to capture the complex interaction that occurs between individuals and their social environment, and the impact this has on their labour market activities. By successfully converting the problem of welfare dependency into a private issue, a neoliberal social policy is legitimised and current social arrangements are maintained.PhD Doctorate
41
Damar, Alita P. "Need analysis for AIDS-related bereavement counselling programmes to assist women affected by HIV/AIDS - an indonesian perspective." Diss., 2008. http://hdl.handle.net/10500/1348.
Full textAbstract:
AIDS-related bereavement counselling programmesThe aim of this study was to determine whether there is a need for specific bereavement counselling programmes for women affected by HIV/AIDS in Indonesia, where death is believed to be fated. Six AIDS-bereaved women were recruited. Data analysis was conducted based on the women's interview transcripts and journal entries. The women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they knew to be mostly associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an "analgesic", while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma.
Sociology
M.A. (Sociology (Social Behaviour Studies in HIV/AIDS))
42
"The development and evaluation of a community-based programme offering psychosocial support to vulnerable children affected by HIV/AIDS, poverty and violence." Thesis, 2004. http://hdl.handle.net/10413/2786.
Full textAbstract:
This research programme endeavours to develop, implement and evaluate an effective method of offering psychosocial support to vulnerable children. Vulnerability is defined by trained community members as including children who are experiencing especially difficult lives. The forms of difficulties experienced by the children has usually been a consequence of the HIV/AIDS pandemic, extreme poverty combined with other psychosocial risk factors, child abuse (especially child sexual abuse) and violence. This community based programme incorporates four phases of intervention, only two of which were the focus of summative evaluation. However, due to the integrated nature of the programme it was necessary to implement and document the various phases of the intervention programme: (i) community selection and mobilisation; (ii) the 5-day Sensitisation Programme (SP) sensitises adult community volunteers to the psychosocial needs of vulnerable children; (iii) the 15-session Structured Group Therapy Programme (SGTP) enables children to work through past adversities and to build resilience within small groups of peers in a programme where community volunteers served as apprentice facilitators under the supervision, guidance and ethical responsibility of qualified psychologists; (iv) community based initiatives to offer on-going of PSS activities to vulnerable children in each of the partnering communities. Nine partnering communities were selected, three township, periurban and rural communities. This programme was not effective in the informal settlements as it was not possible for these communities to place children as a priority. A qualitative summative evaluation of the SP took place using post workshop evaluation questionnaires, focus group discussions conducted by an independent researcher and an audit of the community based initiatives that developed as a result of participation in the SP. The SGTP was summatively evaluated using a 4-way Factorial design with one within-subject and three between-subject conditions: to investigate the age of the subjects, the geographic regions and gender variables. The 741 children formed five experimental and control conditions to conduct various combinations of the above-mentioned phases programmes and to adequately control for the many confounding variables. Pre- and post intervention assessments were conducted by trained community research assistants. The dependent variable measures were the Culture Free Self Esteem Inventory (Battle, 1992), the Trauma Symptom Checklist for Children (Biere & Elliot, 1997), the Reynolds Depression Scale for Children (Reynolds, 1989), the Social Support Scale (Beale Spencer, Cole, Jones, and Phillips Swanson, 1997) and the Connor's Parent Questionnaire Connors, 1998). Multivariate analysis evaluated the effectiveness of the various experimental and control conditions. The results indicate that the SGTP, run in combination with the SP, is an effective intervention strategy in that it alleviates symptoms of self-reported depression and other psychosocial manifestations of distress as well as decreased the number and severity of symptoms reported by primary caregivers, and leads to increased access to perceived social support. The SP and the SGTP conducted independently of each other have limited benefits and as such can be considered to be partially effective. The children who had formed part of the non-vulnerable control group felt left out of the programme and report an increase in symptomatology and decreased access to social support. While this community-based programme can be considered to be an effective method of therapeutic intervention and of offering psychosocial support to vulnerable children, further research is needed to consider the cost-effectiveness, the sustainability and ways in which those children who do not participate can still can benefit.Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.
43
Adamson, Carole. "Complexity and context : staff support systems in mental health after critical incidents and traumatic events : a thesis presented in partial fulfilment of the requirement for the degree of Doctor of Philosophy in Social Work, School of Sociology, Social Policy and Social Work, Massey University, Wellington, New Zealand." 2005. http://hdl.handle.net/10179/1573.
Full textAbstract:
This thesis presents an ecological exploration of the experiences of mental health workers faced with critical incidents and traumatic events in the course of their work. A qualitative study, it takes the experiences of twenty workers from a range of disciplines and environments, and examines their preparation for exposure to extreme stress, their passage through the incidents that they chose to relate, and the organisational response to the events. The central research question explores the knowledge bases currently utilised within trauma and critical incident response, and the degree to which these provide adequate explanatory, practice and evaluation models for responses to workplace incidents. It is examined through the narratives of the mental health workers, who self-define and explore the nature of their preparation for, and experience of, critical incidents and traumatic events in their workplace. The question is contextualised through a review of the knowledge bases of trauma and extreme stress, and of the mental health environment in which the workers practice. A case study of the workplace support known as debriefing illustrates the tensions between current knowledge bases in the area. Informed by this, the key issues of what did or did not work for the participants are explored. The thesis argues that the paradigm shift signalled by the latest developments within conceptualisations of trauma is not yet complete, and that the ensuing tensions have created debate and confusion in the creation of adequate responses to workplace incidents. Whilst conceptualisations that attempt to address issues of complexity and context are evolving, it is argued that an ecological framework has the potential to both explain and respond to incidents that occur within the mental health environment. The findings of the research raise issues of complexity in the design and implementation of appropriate support systems, and lend a perspective to the critique of debriefing that has been missing from existing debates. Key principles for the development of safe and sound support systems, and their evaluation, are developed.
44
Hamilton, Carol Anne. ""In our house we're not terribly sexual" : exploring the barriers to supporting intellectually disabled people in the area of sexuality and intimacy : a thesis presented in fulfilment of the requirement for the degree of Doctor of Philosophy, Sociology, Social Policy and Social Work, Massey University, Palmerston North, New Zealand." 2008. http://hdl.handle.net/10179/843.
Full textAbstract:
How support workers enable, regulate or constrain the sexual expression of intellectually disabled people who live in service agency group homes is the subject of this thesis. A general literature search of what intellectually disabled people currently experience in their lives, including their experiences in the area of sexuality and intimacy, begins this investigation. Secondly, an extensive literature review of the support role, incorporating an appraisal of past and current issues related to the support position in general and to the area of sexuality support in particular, was completed. What intellectually disabled people themselves would like in relation to sexuality and intimacy support was included in this section. Thirdly, a review of research studies focussing on the operation of the support position within service agency systems was undertaken. These explorations revealed a high degree of reluctance on the part of workers to provide assistance in the sexuality area, despite a proven necessity for support to be made available to the intellectually disabled people they worked with. Review research studies suggested a variety of causal factors in explanation of this reluctance. These suggestions link to two meta-reason positions. Failure to prove support either stemmed from individual worker’s inactions due to ignorance and/or incompetence, or from wider systemic failures on the part of agency services to positively value and support this key service role in this area. However, little if any analysis of the possible influence of the broader social, emotional and cultural contexts, in which the concepts ‘sexuality’ and ‘(intellectual) disability’ are located, could be found in the studies reviewed. Eleven in-depth interviews were conducted with front-line support workers about their sexuality support practice. Preliminary readings of the interview texts revealed a similar reluctance on the part of the workers concerned to assist those they worked with in this area. Interview texts were then subjected to a post-modernist inspired, interpretive discursive analysis. This analysis uncovered and tracked how key power/knowledge effects inherent in the terms ‘(intellectual) disability’, ‘sexuality’, ‘gender’ and ‘desire’ inhering in the concept of an ‘ideal (sexual) couple’ interweave to shape the ‘no support necessary’ practice responses held in worker’s interview talk. From this exploration it is suggested that research studies of workers’ practices as an aspect of the promotion of change in support outcomes in the sexuality support area need to go beyond the parameters of recommendations that stem from considerations of either individual or systemic limitation alone. It remains a convincing point to suggest that poorly performing workers need retraining in this area and the overall value of the support role within service organizations needs reshaping. However, future research recommendations also need to engage more directly and effectively with the effects of the wider social and emotional “ideal (sexual) couple” ambiguities that also influence worker’s lack of assistance in this complex and sensitive support area. The use of a post-modern perspective as a helpful conceptual tool in unpacking the power these ambiguities hold within the support position is offered as a productive way forward for future research and practice development.
45
Kiwombojjo, Michael. "The role of capacity building in community home based care for AIDS patients: an exploratory study of Taso : Sseeta-Nazigo Community Aids Initiative." Diss., 2002. http://hdl.handle.net/10500/748.
Full textAbstract:
The focused of this study is the role of capacity building in Community Home Based Care (CHBC) for HIV/AIDS patients. The study forms part of my Master's in Development Administration programme, undertaken through UNISA. The dissertation was accomplished by studying the
TASO community initiative in Sseeta-Nazigo, Mukono District, Uganda. It explores the concept of capacity building and its applicability to CHBC.
The primacy data was gathered by conducting Key Infonnant Interviews (KIIs) and Focus Group Discussions (FGD). The secondary data was gathered by reviewing literature to augment the primary data. In addition, data was gathered through observations within the community.
The fmdings have identified seven critical components of capacity building: community mobilisation, skills development, Information, Education and Communication (IEC) Voluntary Counselling and Testing (VCT), networking and collaboration, support and supervision, Monitoring and Evaluation (M&E). The study observed that capacity built in the above areas resulted in three outcomes: skills development, improvement in procedures, and institutional development. Informed recommendations were subsequently made related to the seven componentsof capacity building in CHBCDevelopment Studies
M. A. (Development Studies)
46
Mooney, Hannah Aroha. "The value of rapport in rangatahi Maori mental health: A Maori social work perspective: a thesis presented in partial fulfilment of the requirements for the degree of Master of Social Work at Massey University, Palmerston North, New Zealand." 2010. http://hdl.handle.net/10179/1363.
Full textAbstract:
This thesis examines the rapport building that occurs between rangatahi Māori whaiora (adolescent Māori who use mental health services) and Māori social workers in the field of community mental health. Six Māori social workers were interviewed to explore how they view and practice rapport building with rangatahi Māori whaiora. The Māori social workers were able to provide valuable perspectives based on years of personal and professional experience. The research was conducted using a social constructionist perspective, informed and guided by Māori-centred research principles. A qualitative research method was used and both Massey University and Māori ethical considerations thoroughly explored. Face to face interviews guided by an integrated practice framework, enabled the voices of the Māori social workers to be heard, eliciting in detail where their views have come from. The findings from the research showed that Māori social workers view rapport as essential in their practice and therefore they practice in a way that facilitates this with rangatahi. The social workers utilise their values and beliefs in their practice, according to their worldview; how they were raised; what they have experienced, and what they have learned. Specifically, Māori social workers identified the importance of practicing with a Māori worldview, therefore enabling physical connection, spiritual connection, and cultural connection with the rangatahi. These all contributed towards rapport building with the rangatahi and also their whānau. The importance of action reflection processes were also highlighted. This is due to the balance required from Māori social workers to fulfil the needs of the rangatahi as aligned with their values and beliefs, while meeting the requirements of the organisation, profession and wider community. This thesis explores these key findings.
47
(11204100), Alia Azmat. "Mind, Body, Spirit: Muslim Women's Experiences in Therapy." Thesis, 2021.
Find full textAbstract:
This dissertation presents in the form of two distinct chapters conceptually related in nature. The first chapter integrates literature from various fields such as indigenous, womanist, and feminist lenses to propose nine principles when working with Muslim women. The purpose of the second chapter is to examine Muslim women’s experiences in therapy at university counseling centers. The study explores women’s experiences from a social determinants of health perspective and a narrative inquiry method—namely, how intrapersonal, interpersonal, institutional, community, and policy factors inform women’s experiences. Qualitative analysis from interviews with six women suggests Muslim women navigate multiple systems which inform their beliefs about health and their experiences in therapy.
48
Nesik, Aleksandra. "Executive Function in the Intellectually Disabled Offender: A Preliminary Investigation." 2008. http://arrow.unisa.edu.au/vital/access/manager/Repository/unisa:36662.
Full textAbstract:
Despite executive function deficits now been examined in relation to the propensity to commit crimes in the general offending population, to date there has been little investigation of this within an intellectually disabled offending sample. The aim of the present study was to undertake a content analysis of the offending patterns and general behavior of Disabilities SA clients with a view to ascertaining whether such an assessment is justified for this offending group. The present study involved content analysis of five participants, currently clients of Disabilities SA. A coding schema was used to assess for evidence of four executive functions: Learning from previous experience; Engaging in logical reasoning; Impulse control; and Understanding the reactions of others. Findings suggest that offenders with intellectual disability have difficulties in all four areas. These findings are discussed in terms of the need for more comprehensive assessment and treatment implications.
49
Mageto, Fred Gichana. "An investigation into social contextual factors that discouraged middle-aged men (30-58) from attending HIV counselling and testing : a case study of Ratanda Heidelberg, South Africa." Diss., 2014. http://hdl.handle.net/10500/15414.
Full textAbstract:
This study investigated social contextual factors influencing poor uptake of HIV counselling and testing (HCT) services by middle-aged black men in Ratanda, Heidelberg. A qualitative research approach was used in which ten men and two key informants were interviewed. Themes explored were the participants’ biographical characteristics; knowledge of HIV and AIDS; health-seeking behaviours; understanding of multiple sexual partnerships and male circumcision and challenges in utilising HCT services. Various social behaviour change theories formed the theoretical framework guiding this study. It was found that fear, stigma and cultural factors largely contributed to poor HCT uptake. Moreover despite the men’s high HIV risk perceptions, behaviour change lags behind. Greater efforts to establish a men’s forum to discuss sexual health matters in Ratanda is recommended.Health Studies
M.A. (Social Behaviour Studies in HIV/AIDS)
50
Kearney, Penelope. "Reconfiguring the future : stories of post-stroke transition." 2009. http://arrow.unisa.edu.au:8081/1959.8/92288.
Full textAbstract:
Stroke recovery is complex and poorly understood. As a legacy of pervasive pessimism in the face of limited treatment, it is conceptualised and researched from biomedical and psychosocial perspectives that address impairment, problems of performance, quality of life, burden and disruption. Little stroke research is conducted once professional input has ceased, and yet considerable change occurs after this period with evidence that post-stroke wellbeing is independent of impairment and function -- many people do well in the face of poor prognoses, while others remain miserable despite 'good recovery'. Current advances in acute stroke management are generating increasing optimism, but lack of understanding about individuals' post-stroke experiences and long-term outcomes continues. While it is recognised that the impact of stroke on the lives of survivors and families is profound, rehabilitation focuses on recovery as task achievement and measured functional outcomes. For many survivors and their families 'recovery' is contested, ambiguous and extended. For some, it becomes a lifetime marathon because stroke represents an assault, not only to the body, but to the self and the lifeworld -- it is a 'life' event. This narrative inquiry into life after stroke explores recovery as a process taking place over time and conceptualised as a life transition. The work is grounded in narrative theory with the concept of transition providing the lens and focus for the research, its processes and analyses. Individuals' stories remain intact enabling evocation of diverse stroke meanings and the mapping of individual experience. Bringing these whole stories into conversation with each other elucidates post-stroke transition which is interpreted in light of theories of response to traumatic loss and informed by narrative theory. The thesis presents stories of trauma, loss and grief, situated in past lives and selves where assumptions about selves and future lives are shattered. The future makes no sense in terms of participants' past and present lives; life plots are lost and stroke therefore represents 'lost futures'. Stories of moving on to new lives are focused on being and doing in the present and have an expectant view of life. Although mindful of past lives and enduring losses, survivors actively engage in processes to reconfigure their lives with hope for a meaningful future. Transition is interpreted as 'reconfiguring the future'. The life tasks of reconfiguration are embedded in dynamic models of traumatic loss where grief is conceptualised as recursive movement between loss and meaning reconstruction evident in narratives that slowly move towards wellbeing. Despite broad recognition that loss and grief are part of the stroke experience, they are rarely addressed; where attention is paid it is likely embedded in explanatory models of staged response that oversimplify human experience. This thesis offers a new framework. It represents a fresh interpretation that highlights the ongoing traumatic impact of stroke. The post-stroke journeys of survivors and families are affected by individual circumstances and meanings. Although their stories are permeated with loss, many people move forward towards lives worth living. This interpretation suggests ways of reconfiguring lives in the face of devastation and ongoing traumatic loss. The work identifies a complex interaction of individual, emotional and social factors contributing to transitions to wellbeing following stroke and thus adds to a prospective vision of post-stroke life that can inform rehabilitation, discharge and stroke support strategies. Post-stroke transition will be enhanced when we use narrative framing and understanding to guide rehabilitative practice that uses meaning-centred models to prepare survivors and their families for a return to the lifeworld.Thesis (PhD)--University of South Australia, 2009