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Saluja, Rohit. "Interpreting Multivariate Time Series for an Organization Health Platform." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-289465.
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Machine learning-based systems are rapidly becoming popular because it has been realized that machines are more efficient and effective than humans at performing certain tasks. Although machine learning algorithms are extremely popular, they are also very literal and undeviating. This has led to a huge research surge in the field of interpretability in machine learning to ensure that machine learning models are reliable, fair, and can be held liable for their decision-making process. Moreover, in most real-world problems just making predictions using machine learning algorithms only solves the problem partially. Time series is one of the most popular and important data types because of its dominant presence in the fields of business, economics, and engineering. Despite this, interpretability in time series is still relatively unexplored as compared to tabular, text, and image data. With the growing research in the field of interpretability in machine learning, there is also a pressing need to be able to quantify the quality of explanations produced after interpreting machine learning models. Due to this reason, evaluation of interpretability is extremely important. The evaluation of interpretability for models built on time series seems completely unexplored in research circles. This thesis work focused on achieving and evaluating model agnostic interpretability in a time series forecasting problem. The use case discussed in this thesis work focused on finding a solution to a problem faced by a digital consultancy company. The digital consultancy wants to take a data-driven approach to understand the effect of various sales related activities in the company on the sales deals closed by the company. The solution involved framing the problem as a time series forecasting problem to predict the sales deals and interpreting the underlying forecasting model. The interpretability was achieved using two novel model agnostic interpretability techniques, Local interpretable model- agnostic explanations (LIME) and Shapley additive explanations (SHAP). The explanations produced after achieving interpretability were evaluated using human evaluation of interpretability. The results of the human evaluation studies clearly indicate that the explanations produced by LIME and SHAP greatly helped lay humans in understanding the predictions made by the machine learning model. The human evaluation study results also indicated that LIME and SHAP explanations were almost equally understandable with LIME performing better but with a very small margin. The work done during this project can easily be extended to any time series forecasting or classification scenario for achieving and evaluating interpretability. Furthermore, this work can offer a very good framework for achieving and evaluating interpretability in any machine learning-based regression or classification problem.Maskininlärningsbaserade system blir snabbt populära eftersom man har insett att maskiner är effektivare än människor när det gäller att utföra vissa uppgifter. Även om maskininlärningsalgoritmer är extremt populära, är de också mycket bokstavliga. Detta har lett till en enorm forskningsökning inom området tolkbarhet i maskininlärning för att säkerställa att maskininlärningsmodeller är tillförlitliga, rättvisa och kan hållas ansvariga för deras beslutsprocess. Dessutom löser problemet i de flesta verkliga problem bara att göra förutsägelser med maskininlärningsalgoritmer bara delvis. Tidsserier är en av de mest populära och viktiga datatyperna på grund av dess dominerande närvaro inom affärsverksamhet, ekonomi och teknik. Trots detta är tolkningsförmågan i tidsserier fortfarande relativt outforskad jämfört med tabell-, text- och bilddata. Med den växande forskningen inom området tolkbarhet inom maskininlärning finns det också ett stort behov av att kunna kvantifiera kvaliteten på förklaringar som produceras efter tolkning av maskininlärningsmodeller. Av denna anledning är utvärdering av tolkbarhet extremt viktig. Utvärderingen av tolkbarhet för modeller som bygger på tidsserier verkar helt outforskad i forskarkretsar. Detta uppsatsarbete fokuserar på att uppnå och utvärdera agnostisk modelltolkbarhet i ett tidsserieprognosproblem. Fokus ligger i att hitta lösningen på ett problem som ett digitalt konsultföretag står inför som användningsfall. Det digitala konsultföretaget vill använda en datadriven metod för att förstå effekten av olika försäljningsrelaterade aktiviteter i företaget på de försäljningsavtal som företaget stänger. Lösningen innebar att inrama problemet som ett tidsserieprognosproblem för att förutsäga försäljningsavtalen och tolka den underliggande prognosmodellen. Tolkningsförmågan uppnåddes med hjälp av två nya tekniker för agnostisk tolkbarhet, lokala tolkbara modellagnostiska förklaringar (LIME) och Shapley additiva förklaringar (SHAP). Förklaringarna som producerats efter att ha uppnått tolkbarhet utvärderades med hjälp av mänsklig utvärdering av tolkbarhet. Resultaten av de mänskliga utvärderingsstudierna visar tydligt att de förklaringar som produceras av LIME och SHAP starkt hjälpte människor att förstå förutsägelserna från maskininlärningsmodellen. De mänskliga utvärderingsstudieresultaten visade också att LIME- och SHAP-förklaringar var nästan lika förståeliga med LIME som presterade bättre men med en mycket liten marginal. Arbetet som utförts under detta projekt kan enkelt utvidgas till alla tidsserieprognoser eller klassificeringsscenarier för att uppnå och utvärdera tolkbarhet. Dessutom kan detta arbete erbjuda en mycket bra ram för att uppnå och utvärdera tolkbarhet i alla maskininlärningsbaserade regressions- eller klassificeringsproblem.
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Runciman, Phyllis Janet. "Interpreting health promotion with older people in community health nursing : education and practice perspectives." Thesis, Glasgow Caledonian University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.547440.
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Caiazzo, Federica. "Mental Health Interpreting: What is at Stake? - The Case of Mothertongue." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amslaurea.unibo.it/17784/.
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Il presente elaborato si propone di esaminare il tema dell’interpretazione nel settore della salute mentale in un panorama internazionale nel quale la migrazione rappresenta un fenomeno sempre più diffuso. Lo scopo è di fornire un’analisi teorica e pratica degli ostacoli e delle implicazioni che derivano dall’utilizzo degli interpreti in questo ambito. La letteratura e le ricerche sull’interpretazione in ambito di salute mentale saranno presentati e affrontati con particolare riguardo al contesto del Regno Unito. Verranno esposte molteplici proposte pratiche con l’obiettivo di fornire una bussola nella creazione di una collaborazione efficace tra interpreti e terapeuti. Il caso pratico di Mothertongue, un’associazione che aveva sede in Regno Unito, servirà infine da esempio di applicazione delle buone pratiche indicate.
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Saulse, Bernice. "Interpreting within the Western Cape health care sector : a descriptive overview." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4213.
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Thesis (MPhil (Afrikaans and Dutch))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Over the past decade many studies have shown that ad hoc interpreting services are still the norm for the health care sector in the South African context. The health care sector of South Africa, specifically in the Western Cape, is characterised by primarily Afrikaans- and English-speaking doctors, or medical practitioners in general, who do not understand Xhosaspeaking patients. In order to bridge this language gap, ad hoc interpreting services are employed, which are rendered by family members of a patient, nurses, or at times, even by porters or cleaners. As a result of the fact that these ad hoc interpreters lack training in interpreting theory and practice, they tend to distort communication, which impact negatively on the quality of the health care that the patient receives. This consequent lack of quality in health care can therefore directly be related to the quality of the interpreted utterances or product that the interpreter renders. Even though ad hoc interpreters are generally more used in the health care sector, some hospitals employ professionally trained interpreters to relieve the burden of a language barrier. In 1996, due to the erratic nature of health care interpreting services and language barriers between medical practitioners and patients, the National Language Project trained 22 community interpreters to be placed in hospitals within the boundaries of the Western Cape. Three of these interpreters were placed at Tygerberg Hospital, three at Groote Schuur Hospital, and three at Red Cross War Memorial Children’s Hospital. By 2008 none remained in Tygerberg Hospital, one was still employed by Groote Schuur Hospital, and two employed by Red Cross War Memorial Children’s Hospital. In 2007, Groote Schuur Hospital identified a need to train and place interpreters within the hospital, due to the language barrier between medical practitioners and patients, as well as to optimise health care. These trainees were formerly employed by the hospital in positions such as cleaners. Even though they were then professionally trained, they were still remunerated as cleaners, for example. In addition to the two interpreters employed at Red Cross War Memorial Children’s Hospital, another interpreter was employed on a full-time basis. Some departments within the hospital make use of their own interpreters, who are not employed by the hospital. Tygerberg Hospital has one officially employed interpreter who is a nursing assistant by profession, and who has received no training in interpreting whatsoever. The aim of this study was firstly to investigate interpreting practices within these three tertiary hospitals, and secondly to investigate the quality of the interpreted product delivered by the interpreters at these hospitals, whether on an ad hoc basis or as professionally trained interpreters. The outcomes of the quality of the interpreted product, measured against a quality table, were compared with the attitudes of medical practitioners, interpreters and patients present in an interpreting session. This was done to determine whether the actual quality of the interpreted product took precedence over the attitudes of the role players, or vice versa.
AFRIKAANSE OPSOMMING: Oor die afgelope dekade het ’n aantal studies aangedui dat ad hoc-tolkdienste steeds die norm vir die gesondheidsektor binne die Suid-Afrikaanse konteks is. Die Suid-Afrikaanse gesondheidsektor, veral in die Wes-Kaap, word hoofsaaklik gekenmerk deur Afrikaans- en Engelssprekende dokters, of mediese praktisyns oor die algemeen, wat nie hul Xhosasprekende pasiënte verstaan nie. Om hierdie taalgaping te oorbrug, word ad hoc-tolkdienste gebruik wat gelewer word deur ’n pasiënt se familielede, verpleegsters en soms selfs portiers of skoonmakers. Omdat hierdie ad hoc-tolke geen opleiding in tolkteorie en -praktyk ontvang het nie, is hulle geneig om kommunikasie te verdraai. Dit lei daartoe dat die gesondheidsorg wat die pasiënt kry, nie na wense is nie. Die gebrek aan kwaliteit van die gesondheidsorg wat die pasiënt ontvang, hou dus direk verband met die kwaliteit van die tolkuitinge of -produk wat die tolk lewer. Ten spyte daarvan dat ad hoc-tolke meer algemeen in die gesondheidsektor gebruik word, het sommige hospitale tolke aangestel wat professioneel opgelei is om die taalgaping te verminder. As gevolg van die wisselvallige gehalte van tolking in die gesondheidsektor en taalgapings tussen mediese praktisyns en pasiënte, het die National Language Project (NLP) in 1996 22 gemeenskapstolke opgelei wat in hospitale binne die Wes-Kaap geplaas sou word. Drie van hierdie tolke is by die Tygerberg Hospitaal geplaas, drie by die Groote Schuur Hospitaal en drie by die Rooikruis Kinderhospitaal. In 2008 was daar nie meer een van hierdie tolke by die Tygerberg Hospitaal nie, een was steeds in diens by die Groote Schuur Hospitaal en twee by die Rooikruis Kinderhospitaal. In 2007 het die Groote Schuur Hospitaal ’n behoefte geïdentifiseer om tolke op te lei en binne die hospitaal te plaas omdat daar ’n taalgaping was tussen mediese praktisyns en pasiënte, asook om gesondheidsorg te optimaliseer. Hierdie persone wat opleiding ontvang het, was voorheen in diens van die hospitaal as byvoorbeeld skoonmakers. Selfs nadat hulle professionele tolkopleiding ontvang het, het hulle steeds besoldiging as skoonmakers ontvang. Buiten die twee tolke wat by die Rooikruis Kinderhospitaal in diens is, is nog ’n tolk voltyds aangestel. Sommige departemente binne die hospitaal gebruik hul eie tolke wat nie deur die hospitaal aangestel is nie. Tygerberg Hospitaal het een amptelike tolk, wat eintlik ’n verpleegassistent is, en wat hoegenaamd geen tolkopleiding ontvang het nie. Hierdie studie het dit ten doel om tolkpraktyk eerstens binne bogenoemde drie tersiêre hospitale te ondersoek, en tweedens om die kwaliteit van die tolkproduk by hierdie hospitale te ondersoek, hetsy die opleiding op ’n ad hoc- of professionele basis geskied het. Die kwaliteit van die tolkproduk, gemeet teen ’n kwaliteitstabel, is vergelyk met die sienswyses van die mediese praktisyns, tolke en pasiënte wat teenwoordig was in ’n tolksessie, om te bepaal of die kwaliteit van die tolkproduk voorkeur geniet het bo die sienswyses van die rolspelers, en omgekeerd.
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Lundin, Christina. "Organizing Language Interpreting Services in Elderly and Emergency Healthcare." Licentiate thesis, Linköpings universitet, Avdelningen för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-145228.
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With an increasing migrant population there is a growing need to organize interpreting practices in healthcare in order to deliver equitable high-quality care. This thesis focuses on healthcare institutions’ organization of interpreting services. The aim of the study was to explore interpreting practices in a healthcare context by comparing two different healthcare areas – elderly and emergency healthcare. The study aimed to highlight the impact of the organizational and institutional context. This study was designed as an explorative and descriptive qualitative study including 79 healthcare professionals with experience of interpreting practices recruited via purposeful sampling in elderly and emergency healthcare. Data were collected through individual and focus-group interviews and analysed with inductive qualitative content analysis. The main findings show that the processes and structures around interpreting practices were complex and mainly linked to individual and interpersonal levels and, to a limited extent, to the institutional level. On the institutional level the Public Procurement Act was the only formal policy to follow. On individual and interpersonal level interpreting practices were structured by self-established informal workplace routines developed by the professional groups. The norms and routines used was determined by access to interpreters, time aspects, characteristics of the care given, health conditions and the person’s problem, expectations and requests from the person and also from healthcare professionals. There were wishes for improvement, with better flexibility in access to professional interpreters, training for users and interpreters, and also better technical solutions and equipment. In conclusion, the use of interpreters was rooted in the organizational environment of interpreting practice, including the availability of laws, policy and guidelines, and closely related to individuals’ language skills, cultural values and social factors. The use of professional interpreters was based on the nature of care in context and access to interpreters and determined by health professionals’ estimation of the person’s current health status in order to deliver fast and individualized care based on humanistic values. Thus, it is important to consider organizational framework and cultural awareness when formulating interpreting practices adapted to the context, and formal guidelines in order to achieve the aim of personcentered and equal health care.
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Kalluri, Radha. "Interpreting otoacoustic emissions in humans : evidence for multiple generating mechanisms." Thesis, Massachusetts Institute of Technology, 2006. http://hdl.handle.net/1721.1/35547.
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Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2006.Includes bibliographical references (p. 110-118).
Healthy ears generate sounds known as otoacoustic emissions that can be evoked and measured in the ear-canal using small, low-noise microphones. The ability to measure acoustic signals that originate within the cochlea provides noninvasive access to what in humans is an almost inaccessible organ. Although otoacoustic emissions (OAEs) are frequently used as noninvasive probes of cochlear function in both the clinic and the laboratory, their utility is limited by incomplete knowledge of their generating mechanisms. A recently proposed model suggests that most OAEs are mixtures of -emissions arising by two fundamentally different mechanisms: 1) nonlinear distortion induced by cochlear traveling: waves and 2) linear reflection 6f those waves from pre-existing micromechanical impedance perturbations. The model predicts that OAEs generated by wave-induced perturbations manifest a phase that is nearly-frequency invariant whereas OAEs generated by reflection from pre-existing perturbations manifest a phase that rotates rapidly with frequency. The model suggests that the relative contribution from each mechanism to any emission measurement depends on factors such as the type and intensity of the evoking stimulus.
(cont.) In this thesis we tested the relationships between common OAE measurements and the two proposed mechanisms of OAE generation. We tested the two-mechanism model by measuring and comparing OAEs evoked with single tones and broad-band clicks, as well as those evoked by two-tone complexes at frequencies not contained in the stimulus, so-called distortion-product emissions. Our results indicate that click-evoked and tone-evoked OAEs, previously regarded as different types of emission based on the characteristics of the stimuli used to evoke them, are really the same emission evoked in different ways. The phase characteristics of both emission types are consistent with those predicted for emissions originating by linear-reflection from pre-existing perturbations. In addition, we demonstrate that distortion-product OAEs are often mixtures of two components. By separating the two components we show that one component arises by linear reflection and the other component arises by induced distortion. Our results provide strong empirical support for the two-mechanism model of OAE generation. Since the two emission mechanisms depend on fundamentally different aspects of cochlear mechanics, measurements that isolate each emission type should improve the power and specificity of OAEs as non-invasive probes of cochlear function.
by Radha Kalluri.
Ph.D.
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Long, Shannon Rene. "PRESERVING, INTERPRETING, AND DISPLAYING MENTAL HEALTH HISTORY: ESTABLISHING THE PATTON STATE HOSPITAL MUSEUM AND ARCHIVE." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/209.
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There are few museums in the western half of the United States that provide an opportunity to educate the public about the history of mental health care. Recently, a mental health museum and archive of artifacts, photographs, and documents was established on the grounds of Patton State Hospital in Highland, California. The purpose of this paper is to reflect on the establishment of this museum and archive and to provide an account of the 125 year history of Patton State Hospital. Understanding the history of Patton provides an opportunity to understand the history of mental health care in the United States from the late 19th century to the present. The establishment of this museum and archive became a joint initiative between Patton and California State University, San Bernardino’s History Department in January 2014. The museum and archive are meant to provide an educational venue that will increase awareness of the plight of the mentally ill, decrease stigmatization of those afflicted with mental illness, and further efforts to improve the care of patients through preservation and display of the artifacts, photographs, and documents related to Patton’s history. The goal of this paper is to assist future public historians with the design and establishment of a museum and/or archive, be it related to mental health history or to projects with other themes, and to provide information to other mental health facilities that wish to establish their own museums.
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Calhoun-Shepard, Rebecca. "Polyamorous Millennials in Therapy: Interpreting Experiences to Inform Care." Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1568762190955648.
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Pineda, Kimberly Rose. "Intercultural communication in healthcare interpreting : an exploration of possibilities." Scholarly Commons, 2010. https://scholarlycommons.pacific.edu/uop_etds/754.
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This thesis will present an exploration of how healthcare interpreters utilize intercultural communication skills as they interact with cultural differences in their work. I will review the literature on healthcare interpreting, including provision laws, standards, codes of ethics, paradigms, and roles. I will focus on intercultural communication literature in order to demonstrate possible ways that it can be applied to the healthcare interpreting field. In order to better understand how intercultural communication is being used in healthcare interpreting, I will conduct interviews with healthcare interpreters who have had intercultural training. In conclusion, elements of a training framework will be introduced that could be developed in order to train advanced interpreters who are interested in using an intercultural approach in their work.
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Sultanic, Indira SULTANIC. "Medical Interpreter Training and Interpreter Readiness for the Hospital Environment." Kent State University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=kent153250300759496.
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Hounton, Sennen. "Application of regression frameworks for presenting and interpreting cost effectiveness analysis of maternal and child health strategies." Thesis, University of Aberdeen, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521317.
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The aim of this work is to explore the feasibility and comparative advantages of the use of regression methods (net-benefit approach) versus standard aggregate measures (incremental cost effectiveness ratio) for presenting and interpreting results of effectiveness and cost-effectiveness of maternal health strategies. Methods: Databases were existing datasets from a Demographic Surveillance Site and a prospective survey on costs borne by women and households for institutional delivery (to evaluate the community based health insurance scheme in Nouna, Burkina Faso), and from a real life evaluation (to asses the Skilled Care Initiative in Ouargaye, Burkina Faso). Results: Regression frameworks are feasible and more practical than traditional aggregate measures of maternal mortality ratio and incremental cost effectiveness ratio. The approach has shown promise by overcoming the shortcomings of the use of aggregate measures by identifying differentials in outcomes by subgroups of populations and by providing useful information on the marginal cost-effectiveness of important covariates. Whilst regression frameworks provide straightforward interpretation and better clues for course of action, the application of the net-benefit approach also provides opportunities for enhancing data collection at Demographic Surveillance Site and national surveys. Indeed, the application of this framework to maternal and child health requires a transformation of current surveys to allow for patient-level data on cost and on effectiveness measures and the use of various stated preference methods for eliciting the maximum contribution communities are willing to pay for extra gain of health outcome or for preventing an extra adverse outcome.
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Öhman, Persson Jenny. "The Obvious & The Essential : Interpreting Software Development & Organizational Change." Doctoral thesis, Uppsala University, Department of Information Technology, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4689.
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Examining how our basic values affect development processes is the overall theme of this thesis. In practice, the question is investigated in relation to software development and organizational change and in research, in relation to science and its relationship to common sense, specifically within the area of Human Computer Interaction. The thesis discusses how it might be possible to discover what is essential for development processes and why the essential may be interpreted as something other than the simply obvious. This thesis examines ways of studying and understanding our social environment and development processes, particularly those concerning people, organizations and software. The empirical examples deal with a software development project and a project that scrutinized the strategy for a governmental authority’s business and information technology. Attitudes are discussed in terms of how they view the user, the customer, the software developers, the software, organizational and implementation processes, organizational management, aesthetic values, functionality and use, research, methods, paradigmatic approaches, ethical issues, psychological reactions, sociological prerequisites, categorizations of people and stress-related health consequences. One particular prerequisite for developing superior computer-supported office work has repeatedly presented itself: an open, questioning attitude towards the software development process, towards organizational change and towards the people working in the organizations. A similar attitude towards research and its design can be crucial to the development of new knowledge. This circumstance can be interpreted as an indication of how important it is that we be aware of and question our preconceived notions, in order to develop an autonomous behavior where we take responsibility for our actions. By doing so, we can avoid misinterpretations and not get trapped into making categorizations that are simply obvious. This is essential and must be emphasized in our search for the path to »healthy work«.
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Williams, Kirsty. "A qualitative study of refugee interpreters' experiences of interpreting for refugees and asylum seekers in mental health contexts." Thesis, University of Leicester, 2004. http://hdl.handle.net/2381/8447.
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Background: Refugees come to Britain from over forty-one countries (Home Office, 2002) and are entitled to the same health care as the local population. As there are few bilingual workers, interpreters are vital (Hodes & Goldberg, 2002). Many interpreters are, however, refugees themselves and have similar histories to their clients (Tribe & Morrissey, 2003), thus the impact that this work has on them is worthy of study. The aim of this research was to gain a better understanding of the professional and emotional needs of refugee interpreters and to use this to develop a theoretical grounding from which to inform clinical practice with interpreters. Method: Semi-structured interviews were conducted with nine interpreters who were refugees. The interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA, Smith, 2004). Analysis: Three super-ordinate themes emerged. (1) Bridging the gap, (2) Vocational Discord, (3) Vocational Catharsis. Theme 1 draws together the interpreters' phenomenological experiences of how they did their work and what doing the work involved. Work was, however, often the catalyst for reflection, re-evaluation and reinstatement of their refugee experiences. Therefore, the impact of work formed the basis of themes 2 and 3. Vocational Discord is illustrative of the conflict and ambiguity present in their role. Work often intensified and/or brought to the fore personal, cultural and societal dilemmas and tensions. Vocational Catharsis (3) the antithesis of discord however, encapsulated how through their work, the interpreters were also able to make sense of their own experiences and in so doing satisfy some of their moral, cultural and humanitarian responsibilities. Implications: The main implications as they relate to clinical work with interpreters and mental health provision to refugees were: value and compassion for the similarity of the interpreters' experiences; non-pathologising supervision and support; clearer definition of the interpreter's role; collaboration and partnership with other professionals; challenging assumptions and accommodating difference in the context of refugee mental health.
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Sin, Kim Fun. "Language and culture in community translation an exploratory validation study of health information pamphlets : thesis submitted to Auckland University of Technology in partial fulfilment of the degree of Master of Arts (Applied Language Studies), 2004 /." Full thesis. Abstract, 2004.
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Thesis (MA--Applied Language Studies) -- Auckland University of Technology, 2004.Appendix 7 not included in e-thesis. Also held in print (245 leaves, 30 cm.) in Wellesley Theses Collection. (T 418.0202461 SIN)
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Grinnell, George C. Clark David L. "On hypochondria: interpreting romantic health and illness (Samuel Taylor Coleridge, Mary Shelley, Thomas de Quincey, Thomas Beddoes, Charles Brockden Brown) /." *McMaster only, 2005.
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Shakespeare, Clare Louise. "Community interpreters speaking for themselves : the psychological impact of working in mental health settings." Thesis, University of Hertfordshire, 2012. http://hdl.handle.net/2299/9156.
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Background: Community interpreters are employed to work across multiple settings in the UK, including mental health services, to support individuals whose first language is not English. To date, little research attention has been paid to the emotional impact of mental health interpreting on community interpreters. Aims: The aim of this study is to develop an in-depth understanding of the emotional challenges of mental health interpreting and the coping strategies employed by community interpreters to overcome these challenges. It is hoped that this research will raise practitioners’ awareness and help guide health services to support interpreters better, to enable the highest standards of care for clients. Methodology: Semi-structured interviews were conducted with eight community interpreters working in mental health settings. The interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Results: Four master themes emerged from analysis: ‘Feeling for the client’, ‘Relationships in Context’, ‘Balancing the personal self and the professional self’ and ‘You need to protect yourself’. These master themes, along with the subthemes contributing to them, are expanded in to a narrative account of interpreters’ experiences. Conclusions: This study has underscored the need for increased provision of support for interpreters, as well as training for practitioners in working with interpreters. Guidance for improved working relationships between interpreters, practitioners and employing agencies is given.
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Kilian, Sanja. "Interpreting within a South African psychiatric hospital : a detailed account of what happens in practice." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79918.
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Thesis (PhD)--Stellenbosch University, 2013.ENGLISH ABSTRACT: It is more than 18 years since South Africa became a democratic country. However, many South Africans are still discriminated against when accessing state services, such as healthcare services (Drennan, 1999). The problem is that healthcare practitioners, in the higher positions of the healthcare system, are commonly made up of professionals who speak only one or at most two of South Africa’s official languages (Swartz, 1998). Due to the lack of funding ad hoc arrangements are made for interpreter-services (Drennan, 1999). Anyone available that can speak even a fragment of the patient’s language, such as nurses, household aides and security guards are called to act as interpreters (Drennan, 1999; Smith, 2011). In many clinical settings, although not ideal, it is possible to treat patients even if there are minimal shared communicative resources (Anthonissen & Meyer, 2008). However, in psychiatric care, language is the primary diagnostic tool, and is one of the central instruments through which patients voice their symptoms (Westermeyer & Janca, 1997). In the Western Cape (one of the nine provinces in South Africa), clinicians working in psychiatric care are mainly fluent in English and Afrikaans. Many Black isiXhosa-speaking patients are not proficient in these languages. The aim of this dissertation is to gain a better understanding of the language barriers facing isiXhosa-speaking patients by focusing on natural conversations, which take place during psychiatric interviews within a particular psychiatric institution in the Western Cape. I made video-recordings of interpreter-mediated psychiatric interviews (n=13) as well as psychiatric interviews (n=12) conducted without the use of an interpreter. In addition, I had discussions (i.e. through semi-structured interviews) with registrars, interpreters and patients to understand their views about issues related to language barriers and interpreting practices. I used an ethnographic approach and the method of Conversation Analysis to understand the study findings. The findings, derived from the psychiatric interviews that were not interpreter-mediated, suggest that the Limited English Proficient (LEP) patients had great difficulty communicating with the registrars. The findings (emerging from the interpreter-mediated encounters and semi-structured interviews), strongly suggest that the haphazard use of hospital employees, who are not trained and employed to act as interpreters, have a significant impact on the goals of the psychiatric interview. In some instances, the use of ad hoc interpreters positively contributed to the successful achievement of the goals of the psychiatric interview. In most instances, the use of ad hoc interpreters inhibited the successful achievement of the goals of the psychiatric interview. One of the most significant findings was that interpreters’ interpretations of patients’ words at times suggest that patients appear to be more psychiatrically ill (increasing the risk for over-diagnosis) than it appears when looking at patients’ original responses. In essence, the lack of language services is unjust towards patients, clinicians, hospital staff acting as ad hoc interpreters, and LEP patients caught in a system, which construct them as voiceless, dependent, powerless, healthcare users.
AFRIKAANSE OPSOMMING: Suid-Afrika is vir die afgelope 18 jaar `n demokratiese land, maar ongeag die afskaffing van apartheid word daar steeds teen baie Suid-Afrikaners gediskrimineer. Dit is veral die geval wanneer Suid-Afrikaners gebruik maak van gesondheidsdienste (Drennan, 1999). Baie gesondheidspraktisyne of dokters is alleenlik vaardig in een of op die meeste twee offisiële Suid-Afrikaanse tale (Swartz, 1998). Ongelukkig weens `n gebrek aan fondse, is die meeste hospitale nie instaat om amptelike tolke in diens te neem nie. Gevolglik word ad hoc reëlings getref wanneer pasiënte tolkdienste benodig. Gewoonlik word enige iemand, insluitende verpleegsters, skoonmakers en sekuriteitswagte, wat selfs net tot `n sekere mate die pasiënt se taal kan praat, gebruik as tolke (Drennan, 1999; Smith, 2011). Die gebrek aan tolkdienste is veral problematies wanneer dit kom by psigiatriese dienste. Dit is omdat in psigiatrie word taal en kommunikasie as primêre diagnostiese instrument gebruik, en pasiënte gebruik hoofsaaklik taal om hul simptome en ervaringe met die dokter mee te deel (Westermeyer & Janca, 1997). In die Wes-Kaap (een van Suid-Afrika se nege provinsies) is die meeste dokters wat in psigiatriese instansies werk hoofsaaklik Engels en / of Afrikaans-sprekend. Baie Swart isiXhosa-sprekende pasiënte, wat gebruik maak van psigiatriese staatsdienste, is egter nie vlot in Afrikaans en Engels nie. Die doel van my proefskrif is om hierdie probleem, wat baie siXhosa-sprekende pasiënte in die gesig staar, beter te verstaan. Ek het besluit om dit te doen deur te fokus op `n spesifieke aspek – natuurlike gesprekke tussen dokters en isiXhosa-sprekende pasiënte. Dokters en pasiënte kommunikeer onder andere gedurende psigiatriese onderhoude, en ek het besluit om video opnames van psigiatriese onderhoude te maak. Ek het die video opnames in `n spesifieke hospitaal in die Wes-Kaap gemaak. Die video opnames het ingesluit psigiatriese onderhoude (n=12) waarin die dokter en pasiënt in Engels kommunikeer, sowel as onderhoude (n=13) waarin die dokter en pasiënt deur middel van (d.m.v) `n ad hoc tolk kommunikeer. Ek het ook gesprekke gevoer (deur middel van semi-gestruktureerde onderhoude) met pasiënte, dokters, en ad hoc tolke om hulle insigte en opinies rakende die bogenoemde taalkwessies beter te verstaan. Verder het ek `n ethnografiese benadering en gespreksanaliese gebruik om die data te benader en verstaan. Die bevindinge wat voortgevloei het uit die psigiatriese onderhoude (beide waarin daar nie `n tolk gebruik was nie, sowel as die waarin daar `n tolk gebruik was) suggereer dat die gebrek aan tolkdienste dikwels die doel van psigiatriese onderhoud ondermyn. Dit komvoor dat in die psigiatriese onderhoude, waarin daar nie tolk gebruik was nie, die pasiënte dit baie moeilik gevind het om met die dokters in Engels te kommunkeer. Dit is waarskynlik omdat hulle nie oor die nodige taalvaardighede beskik om hulleself ten volle in Engels uit te druk nie. Dit kom wel voor dat in sommige gevalle gedurende die psigiatriese onderhoude, waarin die dokters en pasiënte d.m.v.`n tolk gekommunikeer het, het die gebruik van `n tolk `n positiewe impak gehad. Die probleem is egter dat in baie gevalle het dit geblyk het die gebruik van tolke `n ongewenste impak gehad. Een van die belangrikste voorbeelde hiervan is dat die tolke se weergawes van die pasiënte se woorde, dit dikwels laat voorkom asof pasiënte nie juis veel insig in hulle psigiatriese versteurings gehad het nie. Wanneer daar egter gekyk word na die pasiënte se oorspronklike weergawes is dit duidelik dat sommige pasiënte wel insig gehad het. Die bevindinge suggereer hoofsaaklik dat die gebrek aan offisieel en opgeleide tolkdienste onregverdig is teenoor die pasiënte, ad hoc tolke, en die dokters. Dit dra ook by tot `n gesondsheids-sisteem waarin isiXhosa-sprekende pasiënt uitgebeeld word as afhanklik, tot `n groot mate magteloos en sonder `n sê.
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van, Eeden Fay Clare. "Illness and health care in ancient Israel : the role of the social-cultural context in interpreting 2 Chronicles 26:11-23." Diss., University of Pretoria, 2008. http://hdl.handle.net/2263/23979.
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Understanding illness and health care in the ancient world, and especially within ancient Israel, is not an easy undertaking. Most of the research done on Israelite health care focuses on the identification of disease rather than their sociological implications. This study hypothesises that to truly understand ancient Israel’s thoughts on illness and health care it is important to take the wider social context, in which a sick person would have found himself, into account. This study analyses the illness of King Uzziah (2 Chronicles 26:11-23) against the backdrop of the ancient Near East’s understanding of illness and health care, Israel’s view of Yahweh’s role in illness, as well as the interwovenness between illness and the social values of honour and shame. The notions of purity and impurity and the role they played in Israel’s understanding of illness, as well as the role of the temple and other consultative options are also taken into account in the study. In so doing the study intends to shed some light on the interwovenness between illness and social values in ancient Israel and thus enabling a better understanding of 2 Chronicles 26:11-23 and illness and health care in ancient Israel. CopyrightDissertation (MA)--University of Pretoria, 2010.
Ancient Languages
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Manning, Robert K. "The Relationship of Knowledge of the Physiology of Normal and Abnormal Swallowing to Accuracy Interpreting Instrumental Observation of Swallowing." Ohio University / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1015595609.
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Abad, Colom María. "La interpretación de conferencias en el ámbito de las ciencias de la salud en España: situación actual y desafíos derivados del uso del inglés como lingua franca." Doctoral thesis, Universidad de Alicante, 2019. http://hdl.handle.net/10045/96687.
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Esta tesis doctoral aborda la situación actual de la Interpretación de Conferencias en el ámbito de las CC.SS. en España en la era del inglés como lingua franca (ELF) para la comunicación científica. Mediante un estudio cuantitativo y cualitativo, compuesto por más de 600 encuestas y 15 entrevistas en profundidad, se traza el mapa del mercado español actual en este sector para los intérpretes y se ahonda en las consecuencias que la prevalencia del ELF tiene para los científicos españoles. Las implicaciones del uso del inglés como lengua internacional se analizan desde la perspectiva de la Teoría de la Cortesía de Brown y Levinson (1987) y sus conceptos centrales de “imagen negativa”, “imagen positiva” y “acto amenazante a la imagen”. Los resultados de la investigación demuestran que, para los científicos españoles que no dominan el inglés, la ubicuidad del ELF constituye lo que llamamos una “circunstancia amenazante a la imagen” y que la Interpretación de Conferencias puede funcionar como acción compensatoria para preservar la imagen de este colectivo.
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Ewing, Jamesa R. "Training Clinical Judgment Skills for Interpreting Feeding Behavior in Preterm Infants: A Comparison of Video and In Vivo Simulation." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etd/2522.
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Health and feeding outcomes for preterm infants depend upon healthcare providers’ ability to recognize non-verbal signs of distress during bottle-feeding. Methods of training future providers’ to interpret feeding behavior in preterm infants are unclear. This study used a pre-test/post-test design to compare the effects of in- vivo simulation and video-simulation training on students’ knowledge of feeding abnormalities, clinical judgment, and documentation accuracy. Fifty-two graduate level speech-language pathology students were assigned to the in-vivo (N= 27) or video-simulation (N= 25) group. Results revealed that both methods proved beneficial for increasing knowledge and clinical judgment skills. Participants trained using video-simulation training documented a greater number of distress signs. The use of patient simulators to train graduate level speech-language pathology students to use correct clinical judgment for managing abnormal feeding behavior is efficacious.
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Fisch, Mandy. "Interpreting practices in health care : an investigation of differences across trained and untrained interpreters in initial assessment interviews, within the field of Speech-Language and Hearing Therapy." Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/10473.
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Bibliography: leaves 168-181.Interpreting is an act that has become so customary within the South African context that it has become virtually invisible. Most health care institutions rely on ad hoc interpreting, which involves haphazard interpreting arrangements in which anyone who speaks the patient's language, is called on to interpret. Untrained interpreters are consistently used in clinical practice due to a severe lack of trained interpreters. Despite this, to date little research has been conducted investigating the differences between trained and untrained interpreters. Furthermore, little research has been undertaken on the use of interpreters in the field of Speech-Language and Hearing Therapy. There is much need for interpreters within our profession, as clinicians usually either speak English or Afrikaans, with very little or no knowledge of indigenous South African languages. In this study, differences between trained and untrained interpreters were examined in the initial assessment interview, within the field of Speech-Language and Hearing Therapy.
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Warnicke, Camilla. "Tolkning vid förmedlade samtal via Bildtelefoni.net : interaktion och gemensamt meningsskapande." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-57155.
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The Swedish Bildtelefoni.net is a service that people who use Swedish Sign Language (SSL) through a video phone can call in order to get in touch with people who speak through a telephone, or vice versa. In relayed calls via the Swedish video relay service (FBT), the interlocutors have different access to the visual arena and the auditive space. They are also physically separated from each other. An interpreter, working in a studio, enables the interaction across the different media, and the interpreter is the only person who has direct contact with both users of the service. FBT has been provided in Sweden since 1996, and is administrated by The Swedish Post and Telecom Authority (PTS). The overall aim of the dissertation is to describe, analyse and discuss participants’ interaction and their joint construction of meaning within FBT. The theoretical and methodological frameworks for the dissertation are dialogism and Conversation Analysis (CA). The dissertation is based on twenty-five authentic calls from FBT, recorded during two periods of time: in the years 2009–2010, and in 2013. One stimulated recall is also made with one interpreter, concerning a call from the second collection. The project has been ethically approved by the Swedish Ethical Review Board. The interaction within FBT is dynamic and dependent on different media, modalities, resources, and also related to several conventions specific for the setting. All this influences the interlocutors, their actions as well as the entire activity. This kind of complexity has not previously been studied in the regular service. Analysis of the recordings focuses on the actions and activities of the participants who interact in the FBT, on a moment-to-moment basis. As results of the research, four phenomena are addressed, and presented as papers: I: the organisation of turns; II: the headset as an interactional resource; III: positioning and bimodal mediation with a focus on the interpreter; IV: the co-creation of communicative projects among the interlocutors. A main conclusion of the results is that the interaction is a joint construction of meaning among all of the interlocutors, although, the interpreter has a key function. Further research of interaction within FBT needs to be conducted, since investigations on this institutional interaction are rare despite the fact that this kind of service is widespread all over the world.
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Read, Gary Frank Hoyland. "A qualitative study aimed at describing & interpreting the changing symbolic meanings of HIV/AIDS which encountering HIV-positive patients introduces into the personal & professional identities of selected health care professionals." Thesis, Rhodes University, 1993. http://hdl.handle.net/10962/d1002550.
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This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medical practitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS. In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient was elucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purpose the approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily located in interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These two frameworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriate symbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by making suggestions for modification of the medical practitioner's role in the context of HIV/AIDS.
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Vague, Stephanie. "Midwives' experiences of working with women in labour interpreting the meaning of pain : this thesis is submitted to Auckland University of Technology in partial fulfilment of the degree of Master of Health Science (Midwifery), 2003." Full thesis. Abstract, 2003.
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Li, Boya. "Translating Feminism in 'Systems': The Representation of Women's Sexual and Reproductive Health and Rights in the Chinese Translation of Our Bodies, Ourselves." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37813.
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This thesis examines the trans-border circulation and production of feminist knowledge through translation. More specifically, my research focuses the translation of the U.S. women’s health book, Our Bodies, Ourselves, by a Chinese feminist NGO in 1998. My dissertation studies the social, cultural and political aspects of feminist translation, and examines the relation between translation and feminist praxis. Through the lens of gender and (feminist) health politics in 1990s China, I examine how the 1998 Chinese translation conveys the book’s message about how women should relate to their bodies.
Set in the context of Chinese society opening up during the late 1970s, my research outlines the emergence of gender awareness in China with the influx of translated feminist texts, especially in the realm of women’s health research. Medical discourses were then assigned a privileged position in the studies of women’s sexual and reproductive health. However, with increased communications between Chinese and foreign feminists, Chinese women scholars developed new ideas around women’s sexual and reproductive health. The Chinese translation of OBOS addresses the lack of gender awareness in local discussions about women’s health.
With a multi-method study, I emphasize the social and linguistic dimensions of translating a feminist health project into post-reform China. This study is based on both interview and comparative textual analysis data. Using feminist translation theories, I examine how the Chinese translators handled the book’s presentation of women’s sexuality and reproductive health. This thesis also highlights the constraints on translating feminism from the local context. This raises questions about the power of (feminist) translation, and emphasizes the need to examine the social-political context of translation practices.
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Hägglund, Elisabet. "Kandidatuppsats i tolkning : Tolkning av svåra samtal i vården." Thesis, Stockholms universitet, Tolk- och översättarinstitutet, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-153831.
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Bakgrund: Tolkar som arbetar med kontakttolkning t.ex. inom sjukvården utsätts ofta för storapåfrestningar (Baistow 2000 redovisad av Valero-Garcés 2005). Att tolka traumatiska berättelser omtortyr kan återuppväcka minnen hos en tolk som själv varit utsatt för detta. (Lor 2012:17-18). Attvidarebefordra negativa besked till en patient kan också vara smärtsamt för tolken (Butow 2012:238).Tolkar får sällan tillräckligt stöd och handledning i sitt arbete (Butow 2012:240) .Metod: Denna studie består av en enkät till 27 tolkar under vidareutbildning. De har svarat på frågorom svåra tolksamtal, vilket stöd de får och vad de anser skulle behövas för att underlätta derasarbetssituation.Resultat: Många av tolkarna påverkas mycket av att behöva ge negativa besked till patienter och av atttolka traumatiska upplevelser. De får sällan stöd i arbetet och de anser att såväl de själva somtolkanvändarna behöver mer utbildning.Slutsats: Tolkarna behöver mer stöd i arbetet men även tolkanvändarna behöver mer utbildning i attanvända tolk. Det behövs både mer omfattande och fördjupade studier för att komma fram till vilkasatsningar som bäst förbättrar tolkarnas situation och tolkningarnas kvalitet.Background: Community interpreters working in health care often face difficult situations (Baistow2000 described in Valero-Garcés 2005). Interpreters working with refugees often themselves havebeen refugees and when they interpret stories about trauma this might remind them of their own pasttrauma (Lor 2012:17-18). Having to give bad news to a patient can also be painful to the interpreter(Butow 2012:238). In spite of the fact that interpreters have a stressful task, they seldom getappropriate support and guidance in their work (Butow 2012:240).Method: This study is made up of a survey with 27 interpreters undertaking further training. Theyhave been asked questions about to what extent they are exposed to stressful situations, how much thisaffects them and what support they get and what they consider would be needed to improve theirworking conditions.Results: Many interpreters are strongly affected from having to tell the patients bad news and frominterpreting traumatic experiences. The interpreters seldom receive support in their work and theythink they, as well as the health care staff, need more training.Conclusions: Working conditions for the interpreters are demanding and they need more support, butalso the health care staff need more training in how to work with interpreters. There is a need forlarger and deeper studies to decide what has to be done to improve the working conditions for theinterpreters and the quality of the interpretations.
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Koon, A. D. "Framing Universal Health Coverage in Kenya : an interpretive analysis of health financing politics." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/4398421/.
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Universal Health Coverage (UHC), comprehensive access to affordable and quality health services, is a key component of the newly adopted 2015 Sustainable Development Goals (SDGs). Prior to formally adopting the goals at the United Nations in September 2015, several countries began incorporating elements of UHC into the domestic policy arena. Little research has been conducted on the process through which UHC financing policies have been contested in the political realm. In 2013, President Uhuru Kenyatta of Kenya announced initiatives aimed at moving the country towards UHC, which have proven controversial. This study drew on recent theoretical innovations in the field of critical policy studies to examine the ways in which actors understood and engaged with three highly contested health financing polices introduced as part of the movement towards UHC in Kenya: user fee removal, raising contributions to the mandatory health insurer, and the failed 2004 Bill on Social Health Insurance. In addition to document review, this study involved interpretive analysis of transcripts from 50 semi-structured interviews with leading actors involved in the health financing policy process in Kenya. The frame-critical analysis focused on how actors 1) make sense of the policy environment and create meaning through circulating finance ideas; 2) name various elements of the policy design through a process of selecting and categorizing; 3) tell stories and create narratives in ways that illustrate salient features of the process and generate shared understandings. Furthermore, this analysis also focused on what is subject to framing in this dynamic process, including 1) the substantive issues of the policies in question; 2) actor identities and relationships; and 3) the policy process itself. This study found that user fee removal was framed by finance experts as an achievable shortterm target for the Jubilee Coalition’s party manifesto. The rate increase for the mandatory insurer, the National Hospital Insurance Fund (NHIF), was consistently obscured by framing the debate around the shortcomings of NHIF and its damaged legacy. Lastly, the failed 2004 Bill on National Social Health Insurance has since fragmented into several incremental policy proposals that remain the subject of divisive framing contests. This study provides timely insight into the political dynamics surrounding the UHC movement, the policy process for health financing in Kenya, as well as theoretical and methodological considerations for frame-critical policy analysis and the field of critical policy studies more widely.
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Slabbert, Meggan. "Three's a crowd: the process of triadic translation in a South African psychiatric institution." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1002565.
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Mental health care in South Africa has long been governed by inequalities (Foster & Swartz, 1997). During apartheid, those who did not speak English and Afrikaans could not access mental health services in the same way as those who did (Foster & Swartz, 1997). One main reason for this is the majority of mental health practitioners could not, and were not required to speak languages other than English and Afrikaans (Swartz, 1991). The South African mental health literature suggests that language and communication must be prioritised if there is to be an improvement in mental health care services for those individuals who do not speak English and Afrikaans (Bantjes, 1999; Drennan & Swartz, 1999; Swartz & Drennan, 2000; Swartz & MacGregor, 2002). Drawing on Prasad's (2002) interpretation of Gadamer's critical hermeneutic theory and utilising thematic networks analysis (Attride-Stirling, 2001), this study investigated the process of translated clinical assessment interviews within a psychiatric hospital in the Eastern Cape Province within South Africa. Results of the study revealed that contextual factors, issues concerning linguistic and cultural heritage, clinicians' role expectations regarding translators' role performance, as well as relational dynamics regarding individual levels of control and influence within the translation triad, all impacted on the effectiveness of communication, translation and service provision. These fmdings are supported by literature on the theory and practice of translation that identifies these issues as prominent (Robinson, 2003). Specific recommendations regarding the formalisation of translation practices within the hospital setting, as well as the familiari~ation of clinical practitioners and psychiatric nurses with the intricacies of translation processes are offered.
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Christopher, Michael. "An interpretive study of values regarding health, quality of life, and personal relationships held by coronary heart disease patients." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263894.
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Taylor, Margaret A. Paulsen. "An interpretive study of the health experiences of runaway and homeless girls." Access restricted to users with UT Austin EID Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3035986.
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MacDonald, Michael. "Women's deterrence of obesity through exercise adherence| An interpretive phenomenological analysis." Thesis, University of Phoenix, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3708593.
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The present interpretative phenomenological analysis sought exploration regarding the research phenomena of continued obesity deterrence in relation to structured exercise adherence. This qualitative study explored the personal lived experiences of previously obese women between the ages of 20 to 40, and their current coping mechanisms of exercise adherence in relation to the deterrence of obesity. A 10-question interview was implemented to explore the participants’ successful lived experiences toward the discovery of any commonly shared physiological or psychological factors that substantiate health care adherences. The dissertation includes an initial assessment of one participant who responded to pilot test the interview questions; these data were referenced in the collected results. The sample size included 11 participants to determine the estimated independent effect of the research phenomena within the target population demographic. The purposive sample for the study focused only on a successful deterrence of obesity in women recruited from the YMCA health organization in Detroit, Michigan, with signed consent obtained from the Regional Director of Personal Training. Interpretation of the findings for young adult women was that predominately negative external physiological and psychological experiences are initially necessary to self-determine or trigger behavioral change, followed by prolonged positive internal psychological motivators needed to maintain adherence to exercise, culminating with the consistency of routine structured regimen to deter obesity.
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Piper, Stewart. "An interpretive inquiry testing the relationship between health promotion theory and nursing practice." Thesis, Anglia Ruskin University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403617.
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Devereaux, Alana. "Public Health Nurses' Experiences during the H1N1/09 Response." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35260.
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The H1N1/09 (sub-type A) virus was declared to be a pandemic influenza on June 11th, 2009. In response, Canadian public health agencies planned mass vaccination clinics to protect the public. However, little information existed to aid in the planning of mass vaccination clinics, as they had not been used in previous pandemic flu outbreaks. This was further complicated by fear of a limited vaccine supply and nurse shortages. Public health nurses (PHNs), as the largest group of public health professionals were pivotal in implementing the mass vaccination clinics. Yet, the available evidence indicated that PHNs involvement in H1N1/09 response planning was limited and their experiences on the frontline in the mass vaccination clinics were not well understood. The purpose of this study was to give PHNs’ a voice to describe their experiences in the H1N1/09 mass vaccination clinics.
A framework based on Foucault’s concepts of knowledge, power, and resistance was developed as the theoretical lens to guide the research. Using an interpretive descriptive methodology, a purposeful sample of 23 PHNs (16 front-line immunizers, seven clinic supervisors) participated in semi-structured interviews. Four pandemic planning documents containing policies in place during the pandemic outbreak were also reviewed to provide context to participants’ experiences. Interpretive descriptive analysis was used to analyze the interviews and pandemic documents. Guba and Lincoln’s (1994) trustworthiness framework was implemented to evaluate the rigour of the study’s findings.
Two overall core themes emerged to describe participants’ experiences. The core theme ‘the necessity of knowledge’, illustrated participants’ feelings of unpreparedness entering into the H1N1/09 clinics. Limited notice of the pandemic response, uncertainties regarding the clinics’ anticipated timeframe, and a lack of knowledge on vaccination and clinic management, contributed to a loss of power in the participants’ role. In the second core theme ‘essential supports in protecting the population’, many perceived a lack of agency support when they tried to exercise power in their clinical practice. Although participants did not refuse to immunize in, or supervise, the mass vaccination clinics, participants at times did display subtle resistance. Insights gained from participants’ experiences have implications in terms of public health nursing administration, practice, research, and education. A key recommendation is to involve PHNs in future pandemic planning to optimize mass vaccination clinics’ operations. If this cannot happen, PHNs should at least be informed of the disciplinary discourse utilized to guide clinical decisions. This will help nurses be supported in their own pandemic roles and contribute to the provision of quality population care.
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Brookes, Nancy L. "Understanding reflection, an interpretive study among selected practising long-term care nurses." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ66127.pdf.
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Schroerlucke, David. "Choke artists and clutch performers| A Critical Interpretive Synthesis." Thesis, California Institute of Integral Studies, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3643162.
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The colloquial phrases "choke artist" and "clutch performer" are used to refer to individuals who have a tendency to falter or excel, respectively, when performing under pressure conditions. The objective of this study was to conduct a broad survey of the extant literature on the topic of performance under pressure and to offer a Critical Interpretive Synthesis (CIS) of that literature. The output of this project was multi-faceted and included an organized exposition and coarse-grained critical analysis of the literature on performance under pressure, an interpretive synthesis containing multiple suggestions for improving the literature base, and a reflexive account of the experimental use of the CIS methodology.
The critical analysis centered on a critique of the field's predominantly positivistic approach, which has produced a fragmented and ambiguous literature pervaded by enduring difficulties across the domains of conceptualization, research, theory, and practice. The interpretive synthesis was subsequently organized around the theme of advocating for a more balanced and integrative approach to both inquiry and intervention that honors the inevitable role of subjectivity in the pressure-performance relationship.
Specific suggestions for improving the literature base included incorporating a subjective self-assessment component into the operational definition of choking, complementing experimental studies with more qualitative and mixed-methods research, constructing interactional theories of choking that consider the important role of context and meaning-making, and treating athletes and performers more holistically by focusing on personal development and overall well-being in addition to teaching psychological skills.
Perhaps the most provocative suggestion to emerge from the present synthesis is that, as part of a more integrative and holistic approach to psychological training for sport and performance, the Western academic and applied sport psychology communities should begin to look beyond the relaxation and concentration benefits of Eastern mindfulness practices in order to bring into view the potentially broader benefits of the ego-transcendent functions of the spiritual traditions from which these practices derive.
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Williams, A. E. "An interpretive phenomenological study of user experiences of therapeutic footwear." Thesis, University of Salford, 2008. http://usir.salford.ac.uk/2080/.
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Therapeutic footwear is provided to patients with the primary aims of reducing foot pain and improving foot health. Therefore, it is of concern that patients choose not to wear it. This choice has been attributed to its poor appearance. However, there may be other reasons for this choice and the reasons may be more complex than previously acknowledged. Therefore, the aim of this study was to investigate the users’ experiences of this footwear. In the context of this study the ‘users’ are women with rheumatoid arthritis. This study was based on an interpretive phenomenological approach (IPA) that employed conversational style interviews to gather data. Ten women with RA and experience of wearing the footwear were recruited and following ethical approval the interviews were carried out, transcribed, organised and analysed. Five organising themes emerged as findings. These were the participants: • feelings about themselves, • feelings about the footwear, • unmet needs and expectations, • behaviour with the footwear and • feelings about the consultation with the practitioner. The final, global theme was that the patient/practitioner consultation has a powerful influence on the women’s feelings about themselves, the footwear, their expectations of it and their behaviour with it. This study has provided insight into their experiences of this footwear in that, unlike any other intervention, it replaces something that is normally worn and is part of an individual’s perception of self and their perception of how others see them. The footwear impacts more on women’s emotions than previously acknowledged and in addition, it has been found that the consultation influences their emotions and behaviour with the footwear. As well as improvements in footwear design and the service that delivers it, the training of the practitioners in a more patient focussed consultation style could improve the women’s experience and engagement in the footwear as a health intervention, as well as something that is ‘worn’.
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McPherson, Gladys Irene. "Children's participation in chronic illness decision-making: an interpretive description." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/579.
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Participation in decision-making and inclusion in the important matters of one’s life are upheld as measures of equality and indicators of the moral status of individuals in liberal democratic societies. To some extent, the status of children in western societies is a contested question, and hence, the nature of children’s contributions to decisions is a matter of debate. Evidence suggests that in spite of an apparent societal commitment to children’s participation in the important matters of their lives, children tend to be excluded from decisions in which they might reasonably be involved. This project investigated the participation of one group of children—chronically ill school-age children— in decisions related to their health care. Adopting interpretive description as methodology, data were collected and analyzed through interviews and participant observation with 31 chronically ill children (ages 7 to 12 years) and their parents, as well as through interviews with health care providers.
In this study, children’s participation in health care decisions emerged as a complex activity, deeply embedded in relationship and history. Participation varied within two key domains: children’s opportunities and abilities to formulate and make known their intentions and desires in decisional contexts (the resonance of children’s voices); and the standing achieved by children’s views within decisional processes (the relevance of children’s voices). The interplay of adult authority and children’s agency at the nexus of the resonance and relevance of children’s voices created certain participatory spaces, depicted as moral and social realms variously characterized by children’s silence, children’s tangible expression, adult imposed authority, or adult assumed responsibility.
The findings of this study demonstrate a need to re-think our concept of children’s participation, and point to the importance of developing a more relational and contextual understanding of how chronically ill children may contribute to important matters in their lives. The findings also support a view that nurses and other health care providers hold certain responsibilities to critically question the relationships and structures that comprise children’s health care encounters, toward a goal of creating conditions where possibilities for children’s participation are optimized.
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Wang, Tianyu Tom. "Toward an interpretive framework of two-dimensional speech-signal processing." Thesis, Massachusetts Institute of Technology, 2011. http://hdl.handle.net/1721.1/65520.
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Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2011.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 177-179).
Traditional representations of speech are derived from short-time segments of the signal and result in time-frequency distributions of energy such as the short-time Fourier transform and spectrogram. Speech-signal models of such representations have had utility in a variety of applications such as speech analysis, recognition, and synthesis. Nonetheless, they do not capture spectral, temporal, and joint spectrotemporal energy fluctuations (or "modulations") present in local time-frequency regions of the time-frequency distribution. Inspired by principles from image processing and evidence from auditory neurophysiological models, a variety of twodimensional (2-D) processing techniques have been explored in the literature as alternative representations of speech; however, speech-based models are lacking in this framework. This thesis develops speech-signal models for a particular 2-D processing approach in which 2-D Fourier transforms are computed on local time-frequency regions of the canonical narrowband or wideband spectrogram; we refer to the resulting transformed space as the Grating Compression Transform (GCT). We argue for a 2-D sinusoidal-series amplitude modulation model of speech content in the spectrogram domain that relates to speech production characteristics such as pitch/noise of the source, pitch dynamics, formant structure and dynamics, and offset/onset content. Narrowband- and wideband-based models are shown to exhibit important distinctions in interpretation and oftentimes "dual" behavior. In the transformed GCT space, the modeling results in a novel taxonomy of signal behavior based on the distribution of formant and onset/offset content in the transformed space via source characteristics. Our formulation provides a speech-specific interpretation of the concept of "modulation" in 2-D processing in contrast to existing approaches that have done so either phenomenologically through qualitative analyses and/or implicitly through data-driven machine learning approaches. One implication of the proposed taxonomy is its potential for interpreting transformations of other time-frequency distributions such as the auditory spectrogram which is generally viewed as being "narrowband"/"wideband" in its low/high-frequency regions. The proposed signal model is evaluated in several ways. First, we perform analysis of synthetic speech signals to characterize its properties and limitations. Next, we develop an algorithm for analysis/synthesis of spectrograms using the model and demonstrate its ability to accurately represent real speech content. As an example application, we further apply the models in cochannel speaker separation, exploiting the GCT's ability to distribute speaker-specific content and often recover overlapping information through demodulation and interpolation in the 2-D GCT space. Specifically, in multi-pitch estimation, we demonstrate the GCT's ability to accurately estimate separate and crossing pitch tracks under certain conditions. Finally, we demonstrate the model's ability to separate mixtures of speech signals using both prior and estimated pitch information. Generalization to other speech-signal processing applications is proposed.
by Tianyu Tom Wang.
Ph.D.
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Thibeault, Catherine Ann. "The relationships of hospitalized persons with acute mental illness and their nurses: an interpretive inquiry." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=96692.
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The nurse-patient relationship is prominently featured in nursing discourse, particularly in the literature and practices of psychiatric-mental health (PMH) nurses. PMH nurses have found it challenging to focus on their relational work in the face of pressure to provide efficient, technological, and biomedical care, especially in hospital settings. The purpose of this inquiry was to explore the relational experiences of patients with acute mental illness and their nurses in inpatient psychiatric settings. The researcher engaged in conversations with ten PMH nurses and six patients hospitalized with acute episodes of severe mental illness. Interpretation of transcribed accounts yielded four dominant themes: engagement, withdrawal, mindful approach, and keeping safe. The author discusses the relational practices of nurses and their patients as experienced in the day-to-day world of an acute psychiatric inpatient unit. The author explores relational experiences in brief encounters, as patients and nurses move toward the other in order to understand the other; in psychological work, as they attempt to achieve a shared understanding about future directions; and in practices related to caring for patients with physical needs related to activities of daily living. The author discusses the state of unknowing that some patients and nurses experience as they withdraw from the other. The author concludes that relational practices are a prominent feature of the work of psychiatric-mental health nurses in acute inpatient psychiatric units, but that the nature of these practices may be changing. The author also suggests that despite their occasional experiences of nurses' withdrawal and absence, patients highly value the experience of working with nurses in supportive, health-promoting relationships.La relation personnel infirmier-patient a été un élément important du discours en sciences infirmières, particulièrement dans la documentation et la pratique du personnel infirmier en psychiatrie-santé mentale. Les infirmières/infirmiers en psychiatrie-santé mentale rencontrent des difficultés à se concentrer sur leur travail relationnel face à la nécessité de fournir des soins efficaces, technologiques et biomédicaux, particulièrement en milieu hospitalier. L'objectif de cette enquête était d'explorer les expériences relationnelles des patients atteints de maladies mentales aiguës et de leurs infirmières/infirmiers en milieu hospitalier psychiatrique. La chercheuse a engagé des conversations avec dix infirmières/infirmiers psychiatriques et six patientes/patients hospitalisés dans des unités de soins psychiatriques intensifs. L'interprétation de la transcription des conversations a révélé quatre thèmes dominants : engagement, repli sur soi, approche attentive et sentiment de sécurité. L'auteure discute des pratiques relationnelles du personnel infirmier et de leurs patients telles quelles sont vécues dans l'univers quotidien d'une unité de soins psychiatriques intensifs. L'auteure explore ces expériences relationnelles lors de rencontres brèves, lorsque les patients et le personnel infirmier vont l'un vers l'autre afin de mieux se comprendre; lors du travail psychologique, lorsqu'ils tentent de parvenir à une compréhension commune de l'orientation future; et lors des pratiques liées aux soins des patients présentant des besoins physiques en liaison avec les activités de la vie quotidienne. L'auteur discute du sentiment d'ignorance éprouvé par les patients et le personnel infirmier lorsqu'ils s'éloignent l'un de l'autre. L'auteur conclut que les pratiques relationnelles sont un élément important du travail des infirmières/infirmiers d'unités de soins psychiatriques qui ont participé à cette enquête, mais que la nature de ces pratiques pourrait être en train de changer. L'auteur suggère également qu'en dépit des expériences occasionnelles de retrait et d'absence du personnel infirmier, les patients interrogés dans cette enquête accordent une grande importance à la collaboration avec le personnel infirmier dans le cadre de relations de soutien et de promotion de la santé.
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Hussain, Zahid I. "An investigation into information systems development at three National Health Service organisations : an interpretive case study approach." Thesis, University of Manchester, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.488091.
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Ferranto, Mary Lou Gemma. "An interpretive qualitative study of baccalaureate nursing students following an eight-day international cultural experience in Tanzania." Thesis, Kent State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3618896.
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Intercultural competence through study abroad is widely recognized as a preferred teaching approach for the development of globally competent health care practitioners. Colleges and universities are looking for multiple ways to encourage students to study abroad because of the noteworthy effects that these experiential opportunities have on students. Sparse research has been conducted to determine if short-term study abroad trips of less than two weeks are achieving these same outcomes.
The purpose of this basic interpretative qualitative study was to describe the nature and meanings of a short-term international cultural experience for nursing students, and whether or how their understanding of the role of the professional nurse was changed. A group of baccalaureate nursing students traveled to Tanzania and took part in professional and social opportunities over an 8-day period. All participants were required to complete a nursing course with global objectives prior to the trip and pre-immersion seminars. Data were collected from reflective journals during the study abroad experience, focus group discussions one month after returning home, and personal interviews 6 months later. The results indicated that the participants experienced culture shock, but they also gained in self-awareness, cultural empathy, leadership skills, a desire to learn more, and a new perspective of the role of the professional nurse. Langer's theory of Mindfulness, Bennett's Developmental Model of Sensitivity and Campinha-Bacote's Process of Cultural Competence provided the theoretical framework for this study.
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Bromley, Cassie. "An interpretative phenomenological analysis of young people's experiences of living with a parent with mental health difficulties." Thesis, University of Hertfordshire, 2009. http://hdl.handle.net/2299/2803.
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This study examined the local needs of individuals accessing an adult community psychology service, using a cross sectional view of those waiting for the service. This service mapping exercise aimed to gather a better understanding of how the service was operating and the local differences in need. The results showed 163 individuals were waiting to access the service, with the majority (131) waiting for the stand-alone service. The different levels of demand resulted in varying waiting times across the service, with the stand-alone bases accruing the longest and the South-East and West areas producing the biggest relative need. Individuals waiting for the CMHT service were more likely to have two or more presenting problems than those waiting for stand-alone psychology (62.5% and 38.2% respectively). Social phobia and bipolar were more prevalent in the CMHT service, in comparison the stand-alone service had a higher percentage of individuals with depression, obsessive compulsive disorder and post traumatic stress disorder, however the proportions differed between areas. The second part of the study explored the effect on estimated waiting times of improving access to the stand-alone service by devolving it to local CMHT areas. Waiting times varied according to the resource deployment criteria used; relative need proved the most promising. The proposed advantages and disadvantages of reconfiguration demonstrated the complex implications involved, reinforcing the need for clear rationale when considering service restructuring. In conclusion this project highlighted the need for the service to continue tracking demand and individuals’ needs and keep systematic waiting time information for all parts of the service. The results provided a useful starting point to inform future service development, whilst emphasising the necessity for longitudinal data too.
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Bernard, Jean S. "Nurse Educators' Transition to Flipped Classroom: An Interpretive Description Study." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etd/2603.
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To meet learning needs of current undergraduate nursing students, and respond to mandates for bettered prepared graduates, nurse educators must restructure curricula and teaching strategies. One strategy garnering increased attention is the flipped classroom model (FCM). This form of instruction requires students to have access to and be accountable for lecture material on their own time, and then use face-to-face classroom time for interactive learning that can include discussion, case study analysis, or application of pre-class lecture content. Although the FCM has gained popularity, few researchers have fully studied this strategy or considered experiences of faculty who implement the model. Nurse educators, in particular, do not have enough evidence-based information to support use of the FCM. The purpose of this study was to explore and describe undergraduate nurse educators’ experiences associated with the FCM and to elucidate factors which enhance and hinder its implementation. With the analytical approach of interpretive description (ID), the researcher sought to highlight what it is like for educators to teach undergraduate nursing students using the FCM and to offer interpretation of what occurs with transition from traditional lecture to this strategy. Three overarching themes emerged from the data: 1) What We Are Doing Is Not Working: “There’s a Big Disconnect”, 2) Charting a Different Course: Experimenting with the FCM, and 3) Reflections of the Journey thus Far. These themes revealed participants’ motivation for transition to the FCM, their patterns of thinking as they restructured coursework, roles and relationships, and considerations regarding use of this model. Results from this study offer implications for future research and provide undergraduate educators footing for continued evidence-based teaching practice.
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Kortje, Jodi-rae. "Canadian Nurse Leaders' Experiences with and Perceptions of Moral Distress: An Interpretive Descriptive Study." Antioch University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1473624886412243.
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McNamee-Clark, Catherine. "Using interpretive description to explore and evaluate the Providence Health Care goals of care companion card : the clinicians' expreriences." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/45434.
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End of life conversations are challenging in all health care settings, and health care providers’ (HCPs) fears about holding end of life conversations are a barrier to quality patient centred care. This study explored HCPs’ experiences using a conversation “companion card” to structure end of life discussions and sought to understand HCPs’ experiences with goals of care (GOC) conversations.
A theoretical perspective of relational ethics and a research methodology of Interpretive Description (ID) guided this research study. The methodology produced a qualitative description of experiences from a sample of HCPs.
Over a two month period, the researcher gathered data during four semi-structured focus groups with twenty one participants at one urban acute care setting in Western Canada. In addition to focus groups the researcher relied on other processes to enhance her reflexivity, including journaling and memos; all of which are essential to ID inquiry.
The findings of this study centre around four themes relating to participants’ experiences discussing GOC and the usefulness of the companion card in discussions. These themes are titled, the big struggle; responsibility; building relationships and the utility of the GOC companion card. Recommendations from this study addressed the need for research into the ethics of discussing GOC with patients and families with life limiting illnesses; organisational prioritisation ensuring therapeutic GOC discussions take place; incorporation of GOC discussions in educational programs across all health care sectors; and policy reform to ensure community care services can support ongoing GOC conversations.
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Furniaux, Jan. "Lost without translation : understanding restrictive intervention management for people with dementia in a mental health setting : an interpretive description." Thesis, Lancaster University, 2018. http://eprints.lancs.ac.uk/126837/.
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Background: Dementia is characterised by a set of symptoms that affect the functioning of the brain. It is estimated that there are 850,000 people living with dementia in the UK and 46 million people worldwide – more than 60% of whom are women. In the UK, approximately one third of people with dementia live in care settings where staff may apply restrictive interventions guided by legislative frameworks. Aim: To understand the management of restrictive intervention practice by mental health workers in an acute mental health setting for people with dementia. Methods: An interpretive descriptive study was undertaken. Vignettes were developed using evidence based literature, case law and practice guidance and used to frame semi-structured interviews. Mental health workers and practice leaders were purposively sampled and interviewed from an English NHS Foundation Trust which provides mental health services across two counties. Thematic analysis of data was undertaken which followed six phases and utilised NVIVO-10. Results: Four key themes were identified: 1) legislation, 2) policy, 3) training and supervision and 4) person-centred restrictive intervention practice. Discussion: Practice leaders are able to translate knowledge from legislation to frame restrictive intervention policy, practice guidance and training content for mental health workers. Mental health workers can then deliver restrictive intervention practice based on person-centred care principles although specific characteristics such as gender may not be acknowledged as shaping a person’s experience of dementia. A ‘Model of Translated Ways of Knowing’ was developed that demonstrates the knowledge journey from legislation to practice. Conclusions: Restrictive intervention practice can be enabled when legislation, case law, research and national policy are translated into an accessible format for mental health workers. Translated knowledge can then facilitate person-centred restrictive interventions for people with dementia.
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Wybourn, Adele. "Involuntary childlessness : an interpretive phenomenological inquiry into couples' experiences of infertility treatment in the South African public health sector." Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/65623.
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Involuntary childlessness presents an array of far reaching challenges for couples who reside in pronatalistic developing countries. Whilst the literature recognises the diverse difficulties that infertility can present, South African research that centres on the couple system’s experiences of fertility treatment is scant and dated. The goal of my study was to closely explore couples’ joint fertility treatment experiences by providing an opportunity for couples to share their experiences and at the same time for them to make sense of their fertility treatment experiences, the results of which were utilised to establish guidelines for healthcare professionals working in this context. The Reproductive and Endocrine Unit (REU) at the Steve Biko Academic Hospital (SBAH) provided the public healthcare context for sourcing participants for this study. Embracing an Interpretative Phenomenological Analysis (IPA) approach afforded me the opportunity to conduct semi-structured interviews with eight couples over an eight-month period, analysis of which assisted me in gaining an in-depth, experience-near understanding of couples’ joint fertility treatment experiences. The main findings: Participants’ drew on their experiences of private and public healthcare fertility treatment as well as their interpersonal, social, amd spiritual contextual experiences in making sense of their fertility treatment experiences in the public health sector. Couples’ private healthcare experiences were shaped by the unaffordablity and overall disappointment in this treatment option while their public healthcare treatment encounters in contrast were shaped by comprehensive, conversational, informative and facilitative service experiences. Transcending the boundaries of participants’ contextual treatment experiences, couples portrayed their experiences as being further shaped by their interpersonal experiences of their partner as well as their joint coupleship experiences during treatment. Couples experienced treatment as an all-consuming, intrusive process, invading their time, space and thoughts. Although four of the eight couples terminated their fertility treatment due to their inability to financially sustain it, participants shared that the challenges of fertility treatment extended beyond the boundaries of affordability, as it introduced the treated body as a problematic adjunct to their couple relationship. The emotional processes sketched by the couples were etched with emotional highs and lows, which required couples to cope and activate coping strategies in the face of the treatment challenges they faced. Furthermore, couples expressed how their social contexts such as family, friendships, work, community and spirituality shaped their treatment experiences in intricate ways and how this either enabled or inhibited couples to cope during their treatment processes. Taken as a whole, the findings of my study portray fertility treatment experiences as a process rather than a single event (or series of events), which requires the couple to adjust. The implications of these findings are that in planning interventions with couples receiving treatment, healthcare practitioners should consider integrating bio-psycho-social-spiritual elements into the supportive work they do with couples who are receiving fertility treatment.Thesis (PhD)--University of Pretoria, 2017.
Psychology
PhD
Unrestricted
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Mbau, Rahab Waithira. "Influence of organisational culture on the implementation of health sector reforms in low and middle income countries : a qualitative interpretive review." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20919.
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The qualitative interpretive synthesis carried out for this MPH mini-dissertation reviews existing empirical literature for evidence on organisational culture and its influence on the implementation of health sector reforms in Low and Middle Income Countries. This mini-dissertation is organised into three parts: PART A: This is the review protocol which outlines the introduction, the background and the review questions for both the scoping review (which forms section B) and the qualitative interpretive synthesis ( which forms section C) along with their justifications. It also outlines the methodology for both the scoping review and the qualitative interpretive review. The literature search was carried out in eight electronic databases using key search terms developed from the review questions. Inclusion and exclusion criteria were developed to determine the articles for inclusion into the review. All the search terms, data extraction templates and summary tables used in both reviews are provided in this section.
PART B: This is the literature review section which was carried out to map the scope of literature on organisational culture within the health sector in Low and Middle Income Countries in order to support the more detailed analysis in Section C. It begins with a general description of organisational culture and its conceptual frameworks, as well as a description of the tools used in assessing organisational culture that were identified from a broader reading of literature on organisational culture. The reviewer then describes the literature search strategy of the scoping review and maps the retrieved articles based on themes on organisational culture in the health sector. Lastly, the reviewer classifies the different dimensions of organisational culture identified in the reviewed articles using the Competing Values Framework in order to facilitate comparison of organisational culture across the studies.
PART C: This is the full qualitative interpretive synthesis presented as a journal ready manuscript. This review begins with an introduction on health sector reforms and organisational culture. This is followed by a description of the methods used to identify the literature, an outline and synthesis of the findings, discussion section and lastly, the conclusion. The findings of this interpretive synthesis indicate the potential influence of various dimensions of organisational culture such as power distance, uncertainty avoidance, in-group and institutional collectivism, mediated through organisational practices, over the implementation of the health sector reforms. It also highlights the dearth of empirical literature around organisational culture and therefore, its results can only be tentative. There is need for health policy makers and health system researchers in Low and Middle Income Countries to conduct further analysis of organisational culture and change within the health system.
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Orsolini-Hain, Liana M. "An interpretive phenomenological study on the influences on associate degree prepared nurses to return to school to earn a higher degree in nursing." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3324576.
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