Dissertations / Theses: 'Medical referral Psychological aspects'

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July, Emma. "Awareness, attitudes and referral practices of health care providers to psychological services in Botswana." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1166.

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The provision of psychological services is vital considering the complex nature of psychosocial issues facing people today. Nevertheless, the provision and utilization of psychological services has not been given due recognition in most African countries, including Botswana. Botswana is one of the countries faced by the challenges of the HIV/AIDS pandemic and other mental health problems, as well as poverty and unemployment. To date statistics on the magnitude of the HIV/AIDS epidemic in Botswana, published annually by the National AIDS Coordinating Agency (NACA) reflect an increased rate of mental illness and psychosocial problems. Considering the complex nature of issues that impact negatively on people in Botswana, there is a need for awareness and the provision of psychological services in the primary health care system. There is little research on the place of psychology and psychological services in Botswana. The availability of such information is crucial for the planning of effective community-based psychological services. The present study employed a quantitative research method to explore and describe awareness and attitudes towards psychological services and referral practices in relation to psychological problems, of health care providers in Botswana. The participants in the study were chosen, based on a non-probability, purposive sampling method. The sample consisted of ninety-six persons and constituted medical doctors, nurses, psychiatrists, psychiatric nurses and clinical social workers from governmental and non-governmental institutions from Gaborone and Francistown in Botswana. Data were analyzed by means of descriptive statistics in order to identify the mean, ranges and standard deviations. Frequency counts and percentages of the participants’ responses were computed. The results of the study revealed an awareness of available psychological services, positive attitudes towards psychology and psychological services and a reasonable percentage of referrals to psychological services. The results also revealed that available psychological services were limited and not easily accessible to patients. There was also an indication of a shortage of trained professionals to offer psychological services in health care centres, which resulted in psychological problems being referred to social workers.

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Robinson, Derek, and University of Lethbridge Faculty of Education. "Partnerships in performance : effective referral and collaboration between hockey coaches and psychologists." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 2003, 2003. http://hdl.handle.net/10133/204.

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This study investigated the Alberta Junior Hockey League (AJHL) coaches' perceptions of the existing process of referral and collaboration between themselves and psychologists, as well as ways to improve this process. Thirteen of the 15 head coaches were interviewed. The Coach Interview Questionnair provided the framework for the semi-structured interviews. Participants provided responses which included demographic information, information regarding the current referral process, their current level of collaboration, their satisfaction, attitudes and beliefs about referral and collaboration, as well as what player problems require referrals. The findings indicated that there is a substantial need for psychologists to be involved with junior "A" hockey players. A comprehensive guidance and counselling program is recommended to the AJHL in response to the expressed needs for psychological services.
x, 177 leaves ; 29 cm.

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Bélanger, Eliane. "Abortion pain : psychosocial and medical predictors." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74035.

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Roberts, Craig Brendan. "The judgement of risk in traumatised and non-traumatised emergency medical service personnel." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51990.

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Thesis (MA) -- University of Stellenbosch, 2000.
ENGLISH ABSTRACT: Judgement of risk for negative events in certain situations was investigated in a group of emergency medical service (EMS) personnel with a diagnosis of posttraumatic stress disorder (PTSD; n = 27) and a group without PTSD (n = 74). Participants completed the PTSD Symptom Scale: Self-Report version (Faa, Riggs, Dancu, & Rothbaum, 1993), an EMS work experiences questionnaire, the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), and an event probability questionnaire designed to assess judgement of risk. Participants with PTSD overestimated amount of risk involved in comparison to participants without PTSD, thereby demonstrating a judgement bias for risk related events. The present study found that the judgement bias in PTSD participants extended to include not just external harm related events but also general negative events (without potential threatening/harmful consequences), negative social events, and negative workrelated events. Of the posttraumatic symptomatology assessed, avoidance symptomatology was found to be the best predictor of judgement bias. The results of the present study are discussed in terms of the cognitive clinical psychology theories of PTSD, which predict the manifestation of judgement bias in PTSD, and cognitive experimental psychology explanations of the effect of negative emotional states on judgement processes.
AFRIKAANSE OPSOMMING: Oordeeloor risiko vir negatiewe gebeurtenisse in sekere situasies is ondersoek by "n groep mediese nooddienspersoneel met "n diagnose van posttraumatiese stresversteuring (PTSV; n = 27) en "n groep sonder PTSV (n = 74). Deelnemers het die PTSD Symptom Scale: Self-Report version (Foa, Riggs, Dancu, & Rothbaum, 1993), "n mediese nooddiens werkservaringe-vraelys, die Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), en "n gebeurtenis-waarskynlikheidsvraelys wat opgestel is om oordeeloor risiko te meet, voltooi. Deelnemers met PTSV het die mate van risiko betrokke oorskat in vergelyking met deelnemers sonder PTSVen sodoende "n beoordelingsydigheid vir risiko-verbandhoudende situasies gedemonstreer. In die huidige studie is gevind dat beoordelingsydigheid by PTSV deelnemers nie beperk was tot eksterne skade-verbandhoudende gebeurtenisse nie, maar dat dit ook veralgemeen het na algemene negatiewe gebeurtenisse (sonder potensieel skadelike gevolge), negatiewe sosiale gebeurtenisse, en negatiewe werksverwante gebeurtenisse. Daar is gevind dat, wat PTSV-simptomatologie betref, vermyding die beste voorspeller van beoordelingsydigheid was. Die resultate van die huidige studie word bespreek in terme van kognitiewe klinies-sielkundige teorieë van PTSV, wat die aanwesigheid van beoordelingsydigheid voorspel, en kognitiewe eksperimentele-sielkunde verklarings van die effek van negatiewe emosionele toestande op beoordelingsprosesse.

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Reilly, Joanne. "Interventions for the emotional and psychological aspects of having a medical procedure." Thesis, University of Warwick, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502507.

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Recent Department of Health publications have emphasised the desire to provide a more positive experience of the NHS healthcare system, with more choice in a patient-led NHS; improving the management of psychological aspects of a patient's experience is an important aspect to achieving this goal. With these aims in mind paper 1 reviews the published literature for the study of psychological and emotional factors relating to routine elective surgery in the U.K. The effectiveness of interventions is explored. The research methods and design are critically evaluated. Clinical implicationsExisting literature suggests that giving information about a medical procedure can, in some cases, reduce the anxiety experienced. The contribution of service-users to information provision has been largely neglected. With this in mind, paper 2 investigates service-users experience of a colonoscopy to develop an information leaflet, and evaluate its effect on anxiety in patients. No significant difference between the groups in terms of anxiety scores was found. The findings are discussed in terms of current theories in information provision, limitations of the study, clinical application and suggestions for future research. and future research ideas are discussed.

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Lau, Yvonne, and n/a. "The enthusiasm for disease screening : an ethical critique with a sociological perspective." University of Otago. Dunedin School of Medicine, 2009. http://adt.otago.ac.nz./public/adt-NZDU20090121.085918.

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Screening is generally considered a useful strategy in the prevention of chronic diseases. The notion is that early detection through the use of certain screening tests can facilitate effective preventive measures to be undertaken which can then lead to improved prognosis from or ultimate avoidance of serious clinical diseases. The enthusiasm for screening in the United States is high and can be seen by the size of public demand for it. Rapid technological advances and knowledge expansion in the past decade have further facilitated the introduction of new tests and screening opportunities. In the mean time, the concept of screening has undergone subtle changes. Previous emphasis on clear and demonstrable population health benefits has been slowly replaced by an emphasis on individual responsibility for the surveillance of personal health risks. Disease screening is frequently advocated as part of a health promotion programme. As a clinician who has worked in breast cancer screening and who is wary of the complexities and problems associated with disease screening, my contention is that the enthusiasm for screening may not ultimately be conducive to health and well-being. This thesis represents an effort to understand the popularity and enthusiasm for disease screening, how it has come about and, why it may not be conducive to health and well-being. The thesis begins with a description of the phenomenon to be followed by a detailed examination of the scientific principles behind disease screening. It then moves on to discover how the phenomenon might have come about by first considering the evolution of biomedicine over the centuries and then its present endeavour in the form of surveillance medicine as well as the latter�s relationship with today�s market economy. Using relevant case studies that involve, for example, cancer and prenatal genetic screening, this thesis explores different concerns relating to health and well-being, including such topics as the creation of health roles, the reconfiguration of human values and interpersonal relationships as well as medicalisation. A final chapter offers an account of health and well-being and sums up why the enthusiasm for screening may not be conducive to health and well-being. The enthusiasm for screening compels people to assume health as a moral virtue. Screening is turned into a ritual that people consume to attain salvation. Since diseases may lead to death, diseases must be avoided though screening. Yet health is not just about the absence of disease. Health and well-being can only be realised by the individual within the context of the individual�s life as a whole. The institution of biomedicine has undeniable responsibility to ensure that screening will not be used to the detriment of individuals� health and well-being. Without condemning disease screening as a potentially useful tool in the prevention of disease, this thesis advocates prudence in its utilisation. People must not be compelled to attend screening through programmes of promotion (commercially related or not). Rather, autonomous decisions must be facilitated as far as possible through the provision of clear, accurate and factual information.

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Au, W. M., and 區慧敏. "Childhood obesity in Hong Kong: medical and psychological sequelae." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31971416.

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Palazzo, Michael. "Pilot Testing a Paperless Nursing Assessment of Medical, Psychiatric, and Addiction Treatment and Re-entry Needs Among Women at Jail Intake." Diss., University of Hawaii at Manoa, 2010. http://hdl.handle.net/10125/22062.

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This research was a pilot study at improving the medical, psychiatric and addiction care provided to women detainees at the jail. Few studies have been completed with women atjail intake, yet the population is suspected of having a multitude of medical, psychiatric and addiction in jail treatment and community reentry needs. Utilizing a descriptive, cross-sectional survey design, the following aims were completed for this pilot study: documented the creation of a nursing research infrastructure within a large jail; compared the results of the traditional 16- item paper and pencil Intake Service Center Screen with the 8-item paperless Brief Jail Mental Health Screen obtained via Audio Computer Assisted Self Interviewing (ACASI) technology; compared Addiction Severity Index scores and addiction treatment motivation and readiness scores obtained via ACASI technology with normative data; assessed the frequency of HIV risk behaviors and the medical, psychiatric and addiction treatment needs obtained via ACASI technology; while assessing the frequency and the average length of time for screening by providers at the jail via medical chart review. The results showed that the ACASI technology proved to be more effective than paper and pencil methods. This technology not only assessed detainee treatment needs, but simultaneously created reentry/discharge plans. The study demonstrated that HIV risk behaviors and the prevalence of past suicide attempts were high among the participants. The Addiction Severity Index scores and the Circumstance Motivation and Readiness scores demonstrated that methamphetamine addiction, and mental health severity is high among this population however motivation and readiness for treatment arc low. Therefore, recommendations for the most suitable jail psychiatric Advanced Practice Registered Nurse candidates could be given as a result of the study. This study was the first phase at improving the medical, psychiatric and addiction care provided to detainees at the jail. In future phases of this study more valid and reliable assessment tools and treatment planning aimed at reduced recidivism rates will be established. Future phases will build on the lessons learned here about working with security staff, collaborating with experienced researchers in the community, and seeking advice from the Department of Justice recognized experts.

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Maldonado, Michele L. "The Effects of Parenting Stress and Academic Self-Concept on Reading Ability in a Clinic Referral Sample." Thesis, University of North Texas, 2001. https://digital.library.unt.edu/ark:/67531/metadc2751/.

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This study investigated the relationships among the variables of parenting stress, academic self-concept, and reading ability. The purpose of this study was to determine whether parenting stress and academic self-concept contributed to the child's reading ability. Two hypotheses were investigated in an effort to accomplish this purpose. The subjects used in this study were forty-nine children and their primary caretakers referred to The Child and Family Resource Center, The University of North Texas, Denton, Texas, during the academic years of 1994 through 1999. Subjects ranged in age from seven to eighteen years of age. Academically, the subjects ranged from first graders through eleventh graders. All subjects lived in and attended schools in Denton County or neighboring counties. Parental employment ranged from unskilled laborers to medical doctors. The participating families included biological, step, adoptive, single, and divorced families. Abidin's Parenting Stress Index was used to measure parental stress experienced by the primary caretaker. The Intellectual and School Status cluster of the Piers-Harris Children's Self-Concept Scale was used to measure the child's academic self-concept and the Woodcock Reading Mastery Test-Revised provided a measure of the child's reading ability. Test scores were obtained following a review of The Child and Family Resource Center's documented files. Multiple regression statistics revealed no significant relationship between neither parenting stress and the child's reading ability nor the child's academic self-concept and reading ability. Standardized beta coefficients and bivariate correlation results indicated a relationship between academic self-concept and reading ability. Additional research is recommended for future research that encompasses a larger and more diverse sample.

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Yagi, Toyoko. "Compliance with dialysis regimens: The effects of coping and social support." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2655.

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The purpose of this study was to identify determinants of compliance behavior. Since compliance among dialysis patients increases survival rate, it is important for social workers to identify patients who are at risk of noncompliance.

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Nakamura, Carlos. "The effects of specific support to hypothesis generation on the diagnostic performance of medical students /." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102817.

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The hypothetico-deductive method, which involves an iterative process of hypothesis generation and evaluation, has been used for decades by physicians to diagnose patients. This study focuses on the levels of support that medical information systems can provide during these stages of the diagnostic reasoning process. The physician initially generates a list of possible diagnoses (hypotheses) based on the patients' symptoms. Later, those hypotheses are examined to determine which ones best account for the signs, symptoms, physical examination findings, and laboratory test results. Hypothesis generation is especially challenging for medical students because the organization of knowledge in medical school curricula is disease-centered. Furthermore, the clinical reference tools that are regularly used by medical students (such as Harrison's Online, UpToDate, and eMedicine) are mostly organized by disease. To address this issue, Abduction, a hypothesis generation tool; was developed for this study. Sixteen medical students were asked to solve two patient cases in two different conditions: A (support of clinical reference tools chosen by the participant and Abduction ) and B (support of clinical reference tools chosen by the participant). In Condition A, participants were able to generate the correct diagnosis in all 16 occasions (100%) and were able to confirm it in 13 occasions (81.25%). In Condition B, participants were able to generate the correct diagnosis in three out of 16 occasions (18.75%) and were able to confirm it once (6.25%). The implications of this study are discussed with respect to the cognitive support that Abduction can provide to medical students for clinical diagnosis.

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Palmer, Josephine Chiara. "Factors associated with professional nursing practice in medical-surgical nurses." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277266.

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The purpose of this study was to identify and describe factors perceived to be important to nursing practice by registered nurses. The sample, 170 medical-surgical nurses, was 37% of the total in the primary study (N = 455). An exploratory/descriptive design was used to content analyze the qualitative data obtained from one open-ended question asked in the Differentiated Group Professional Practice in Nursing project. Results showed two concepts in the conceptual framework, Group Cohesion and Job Satisfaction, with regard to Pay and Physician/Nurse Relationships, were supported. Other categories generated included the importance of Administrative Support, both Nursing and Non-Nursing, Education, Adequate Staffing, Flexibility in Hours, and Role Recognition. Another set of responses were categorized as Conflicts - Dissatisfiers. Categories generated included Entry into Practice, Non-Nursing Functions and Changing Attitudes.

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Yeung, Sze-ying, and 楊思瑩. "A case control study of the referral pattern and patient non-attendance in medical and surgical specialist outpatient clinics inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B39724293.

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Ferro, Paula Luz, and Fernandez Gloria Del. "Spirituality and compliance correlates of hemodialysis patients." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2663.

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The purpose of a study of spirituality and its relationship to the compliance of hemodialysis patients is to consider changing the approach of the treatment team in the dialysis setting. The interdisciplinary treatment team at the dialysis center consists of physicians, nurses, dietitians, and social workers. One of the many roles of the dialysis social worker is to facilitate the adjustment to and acceptance of the patient's need for dialysis.

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Szentesi, Christine Eve. "Women's medical facilities : rethinking program with regard to the patient." Thesis, Georgia Institute of Technology, 1995. http://hdl.handle.net/1853/24071.

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Thomson, Cynthia 1957. "INFLUENCE TECHNIQUES OF CLINICAL DIETITIANS WHEN INTERACTING WITH PHYSICIANS." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276483.

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A national study of clinical dietitians was undertaken to determine: (1) current clinical activities performed, (2) techniques used to influence physicians and (3) level of confidence for successfully influencing physicians in seven areas of practice. Questionnaires were received from 458 (77%) of the dietitians. Data indicate dietitians are less likely to participate on patient care teams and attend medical/surgical rounds, but more likely to check meal trays than their 1982 counterparts. Factor analysis of clinical activities revealed three postures: diet oriented, physician oriented and case oriented. Factor analysis of the influence techniques, identified five postures: block/threaten, ingratiation, coalitions, assertive and the most used posture, rationality. Multiple regression analysis found associations between age and education and the use of rationality and ingratiating postures and between age and the assertive posture. Frequency analysis of confidence levels found dietitians most confident influencing the physician in the area of food consistency modification and least confident in nutritional laboratory data.

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Willis, Eileen. "Accelerating control : an ethnographic account of the impact of micro-economic reform on the work of health professionals /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phw7341.pdf.

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Skidmore, Monique. "Flying through a skyful of lies : survival strategies and the politics of fear in urban Myanmar (Burma)." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=35670.

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This thesis concerns the cultural construction and mechanics of violence, domination, and survival under a Southeast Asian totalitarian regime. It entails an examination of the modern character of violence and domination in Myanmar (Burma) through the inscription of State power upon the bodies of Burmans and via the ramifications of the regime's alliance with the drug lords upon the urban struggle for survival. At times of extreme domination, fear, and degradation, very little space exists for psychological and physical resistance. Burmans seek escape from this situation by withdrawing into domains characterized by denial, numbness, and temporary madness. My concern is with the lived experience of totalitarianism, the way that individuals respond differently according to a prior series of lived experiences, and the particular idioms drawn upon to construct survival strategies.
An important culturally constructed strategy of survival in Myanmar entails the detaching of agency from the body while the mind "flies" to freedom. This strategy has a long history not only in Burmese, but also in other Southeast Asian histories, myths, and legends. Just as Burmese wizards fly to a mythical landscape in the foothills of the Himalayas when released from their physical bodies, so too do heroin addicts, prostitutes, psychiatric patients, and the urban poor flee to Burmese fantasylands to escape the domination of the military regime. This strategy, one of many adopted by urban residents, denies the State the final prize it so desperately craves: the willing participation of Burmans in a military society, the complete internalization of totalitarian ideology such that no other ideologies can exist and no space is left for their creation and negotiation. In the conclusion I argue that the regime is aware that it has faded in this task.
I also examine the possibility that the existence of multiple Burmese worlds or realities, in conjunction with a strong belief in the miraculous may offer new ground for research into the trauma of survivors of violence and terror. The construction of madness, death, and reanimation in Burmese culture, grounds particular survival strategies in logical, hopeful, and perhaps curative, rationalities.

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Boyd-Flanagan, Sandra L. "A comparative study: Health care providers and student attitudes towards persons with HIV seropositivity or the definitive diagnosis of AIDS." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/430.

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DiDona, Toni Marie. "An evaluation of depression, self-efficacy, satisfaction with life and perceived access to medical care across stages of HIV infection." FIU Digital Commons, 1994. http://digitalcommons.fiu.edu/etd/2815.

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This survey was designed to identify the incidence and scope of depression, satisfaction with life, self-efficacy and perceived access to medical care for those who are infected with the HIV virus. It also determined whether or not factors such as sexual orientation, ethnicity and socioeconomic status are intervening variables with respect to mental health issues. Subjects were recruited through a purposive sample from South Florida. A total of 871 surveys were used in the analysis. The overall response rate was nearly 90%. The incidence of depression was found to be higher than 75% across all stages of HIV infection. Furthermore, the incidence of depression increased as HIV disease progressed. Satisfaction with life and for the most part, self efficacy were found to decrease slightly as HIV disease progressed. Significant variance in depression, life satisfaction and self efficacy were found across stages of HIV infection. No significant differences between groups that were HIV infected, were found for depression, life satisfaction and self efficacy. The severity of depression was found to vary significantly with self efficacy, life satisfaction and access to medical care but not with socioeconomic status. Life satisfaction was found to vary significantly with socioeconomic status, depression and self efficacy but not with access to medical care, Self-efficacy was found to vary significantly with socioeconomic status, depression and life satisfaction but not with access to medical care. Gender and ethnicity were not found to be significant precedent variables in depression for HIV infected individuals. Sexual orientation was found to be a significant precedent variable for depression, life satisfaction and self efficacy.

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Wong, Shan. "Psychological reaction of healthcare workers in the outbreak and aftermath of severe acute respiratory syndrome." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29760239.

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Keenan, Lisa A. "Family Environment, Social Support, and Psychological Distress of Women Seeking BRCA1 and BRCA2 Genetic Mutation Testing." Thesis, University of North Texas, 2002. https://digital.library.unt.edu/ark:/67531/metadc3240/.

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Shared characteristics and predictors of psychological distress are beginning to be identified in research on women seeking genetic testing for BRCA1 and BRCA2 gene mutations. This study further explored patterns of psychological distress for 51 community women waiting to receive such genetic test results. There was no significant relationship between psychological distress and family cancer history, personal cancer history, social support networks, and family environment. Women in this sample tended to rely more on females and relatives for support than males and friends. Social support satisfaction was not related to gender or number of relatives providing support. Thirty-four of the 36 women classified on the family environment type were from Personal Growth-Oriented families. Comparisons with normal and distressed family means revealed increased cohesion and expressiveness with decreased conflict, indicative of supportive family environments. Limitations and implications are discussed.

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Cruz, Leo Joe. "Medical compliance for Hispanic patients with end stage renal disease." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1798.

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Catalanello, Michael S. "Relaxation and Cognitive Therapy: Effects upon Patients' Abilities to Cope with a Stressful Medical Procedure." Thesis, University of North Texas, 1990. https://digital.library.unt.edu/ark:/67531/metadc332308/.

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This investigation evaluated the efficacy of relaxation training and cognitive therapy separately and in combination in enhancing the coping skills of patients during epidural steroid injections. Subjects consisted of 80 back pain patients. They were randomly assigned to four groups to receive either relaxation training, cognitive therapy, relaxation and cognitive therapy, or attention control treatment. All subjects were provided preparatory information describing the procedure for the epidural injection and typical physical sensations experienced by patients undergoing the procedure. Relaxation training consisted of Jacobsonian progressive relaxation instructions which were modelled by the trainer. Cognitive therapy consisted of instructions and a work sheet designed to assist subjects in designing positive (rational) self statements concerning the injection procedure. Attention control procedures involved instructions and written exercises of equal duration to the relaxation and cognitive treatments but containing no instructions for the control of anxiety and pain. The three experimental groups exhibited significantly fewer "ae1f-distress" verbalizations during the injection. On other dependent measures, namely, the remaining catagories of pain verbalizations, gross body movements, heart rate, and independent ratings of anxiety there were no significant differences among experimental and control groups. Results are discussed in terms of spontaneous use of coping skills, habituation, individual differences in predisposition to specific coping strategies, and possible cultural/class/educational correlates of specific coping strategies. Improvements in methodology and directions for future research are recommended.

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Arias, Rosa, and Flora Irene Dharmaraj. "Levels of subjective quality of life among adults with psychotic disorders formerly in foster care: Compared to a matched sample." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3117.

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The purpose of this study was to explore whether or not adults with psychotic disorders, who were formerly in foster care, are more likely to report a lesser quality of life as compared to a matched sample with no history of foster care.

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Johnson, Steve Armenta. "Stress, coping and adjustment in single and married medical school students." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1268.

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Ataie, Jutta Elisabeth. ""Who Would Have Thought, With a Diagnosis Like This, I Would be Happy?": Portraits of Perceived Strengths and Resources in Early-Stage Dementia." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1107.

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This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response. Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption in well-being. For the participants in this study, learning to live with the illness was an ongoing, continually shifting process of adjustment, where the participants moved from a familiar sense of well-being to an alternative sense of well-being. In this process the participants used a variety of strengths and resources ranging from those that supported them in reconstructing identity, regaining control, and rebuilding relationships to those that assisted them in reestablishing a healthy lifestyle and restoring meaning and purpose. Striving toward well-being while acknowledging the inconceivable notion of losing one's cognitive abilities was the central strength that the participants brought to this process. It captured the paradox the participants faced in living with early-stage dementia, which was to relegate the illness to the background of their lives while managing its symptoms in the foreground.

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Reynolds, Carol A. (Carol Ann). "Attitudes of Nursing Faculty Toward Patients With AIDS and Patients With a Homosexual Lifestyle." Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc332811/.

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The purposes of this study were (1) to determine whether patients with AIDS are stigmatized by nursing faculty, (2) to determine whether practicing homosexuals are stigmatized by nursing faculty, (3) to determine whether faculty attitudes toward AIDS patients are influenced by the patients' sexual preference, and (4) to determine whether faculty attitudes toward practicing homosexual patients are influenced by the patients' disease. This study is a modified replication of studies by Kelly et al.

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Yiu, Man-ching Phebe, and 姚文靜. "A study of the psychosocial aspects of long term hospitalization with reference to spinal injured patients: implication for social work practice." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1988. http://hub.hku.hk/bib/B31248329.

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Leung, Lok-lam Lorraine, and 梁洛林. "An exploration study on the relationship between styles of coping, andphysical and mental well-being of social workers in medical socialservice units under the Social Welfare Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45014516.

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Kenney-Moore, Patricia. ""Like Drinking Water Out of a Fire Hydrant" Medical Education as Transformation: A Naturalistic Inquiry Into the Physician Assistant Student Experience." PDXScholar, 2016. http://pdxscholar.library.pdx.edu/open_access_etds/2711.

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Physician assistants are medical professionals educated in an allopathic medical education model in the United States. In order to successfully matriculate, educate and graduate safe and effective health care providers in a 2-year time frame, the 4-year M.D. curriculum has been abbreviated and condensed leading to an intense, full-time cohort educational experience that taxes physician assistant students to their limits. The demanding workload can lead to fluctuations in mood and morale along with increased levels of psychological distress. This dissertation explores this under examined student experience by first introducing the physician assistant profession and the process by which it educates its members. The cohort patterns of mood and morale observed by faculty during the educational process are described using the conceptual and theoretical models of transformative learning, transition, change and cross-cultural adaptation as explanations for the observed experience. A retrospective naturalistic research paradigm utilizing focus groups elucidated the student perspective of the cohort medical education experience over the course of the didactic curriculum, and study results highlight a three-stage experience consistent with stages-of-change theories from multiple disciplines. In addition, a prominent pattern of emotional subthemes provide a window into the psychological significance of this transformative experience. A better understanding of the effects of this academically rigorous and psychologically challenging medical education process on physician assistant students clarifies opportunities for amelioration of student challenges while simultaneously enhancing the ultimate goal of developing safe and effective health care providers.

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Rosario, Douglas Paul. "Compliance behavior in physical therapy home programs." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1658.

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Binti, Mohd Arifin Siti Roshaidai. "Perspectives of postnatal depression in Malaysia : exploring experiences of women and healthcare practitioners." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/24176.

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Background: Postnatal depression (PND) is one of the most common maternal mental health problems for women worldwide. Yet the wide range of reported rates of PND in different countries raises questions about how PND is experienced by women in different cultures and whether interventions developed in western cultures are appropriate in very different settings. It is important to establish how PND is defined, experienced and managed in different cultures in order to create culturally relevant interventions. No previous studies of experience of PND and its management have been conducted in Malaysia. The aim of this study was to explore women’s experiences and healthcare practitioners’ (HCPs) perspectives of PND in a multicultural country, Malaysia. Methods: This was a qualitative study informed by a critical realist approach. Semi-structured interviews were carried out with 33 women (from three different cultural backgrounds) attending for child or postnatal care and 18 HCPs in six purposively selected maternal and child health (MCH) clinics and a female psychiatric ward in Kuala Lumpur, Malaysia. Data were analysed using framework analysis. Findings: There were some differences in the women’s perceptions of PND experience across three different cultural backgrounds in Malaysia. Malay women were more likely to describe the symptoms of PND based on a combination of emotional and behavioural changes, whereas Chinese and Indian women talked more about emotional changes. Traditional postnatal practices were described as contributing to PND by some Malay women but were accepted as promoting maternal and infant well-being by the majority of Indian women. Religious activities were reported as an effective strategy for the Malay women but were not seen as helpful by the majority of Chinese women. Considering HCPs, it appeared that the absence of a clear and specific policy and guideline in the management of PND within the Malaysian healthcare system has resulted in a lack of professional ownership in the management of PND, especially among HCPs in MCH clinics. Conclusion: The women and the HCPs had distinct ways of conceptualising PND experiences, although they agreed on several symptoms and causal explanations. This study calls for a system-based enhanced PND care with an initiation of culturally appropriate care for PND within the healthcare system.

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Shamberg, Neil S. "Shell shock in the origins of British psychiatry." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1045637.

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This study has presented a comprehensive overview of the origins of modern British and American military psychiatry, chiefly in response to World War I shell shock. The study examined the state of British psychiatry during the nineteenth century, as the new railroads, mines, and factories produced accident victims with post-traumatic stress disorders. As World War I began, psychoanalysis was in its infancy, and most British psychiatrists faced with a victim of shell shock fell back on an eclectic mix of treatments, including electro-shock therapy, hot baths, massages, moral persuasion, lectures, exhortation, etc. While a few British and American psychiatrists practiced either psychotherapy or disciplinary methods exclusively, the majority of practitioners used a variety of methods, depending on the doctor's point of view and the circumstances of the case at, hand. Psychotherapeutic developments in the inter-war period are also explored and discussed.
Department of History

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Costa, Clara Kislanov da. "A urgência subjetiva na urgência e emergência médicas: a inserção da escuta psicanalítica no pronto-socorro." Pontifícia Universidade Católica de São Paulo, 2017. https://tede2.pucsp.br/handle/handle/20259.

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Made available in DSpace on 2017-07-28T12:37:48Z (GMT). No. of bitstreams: 1 Clara Kislanov da Costa.pdf: 825858 bytes, checksum: 0c59c010044af05cc25c4d1444454bd3 (MD5) Previous issue date: 2017-07-21
Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
The presence of the psychoanalyst in the hospital’s emergency room still raises questions about what this professional is capable of doing in such place. The main goal of this research is to understand what is the role of the psychoanalyst in the emergency service, given the hurdles he/she can find due to a different look and a specific sense of ethics in this environment. To achieve this goal, a qualitative research was carried out, based on a theoretical discussion and a psychoanalytical reading which, in its turn, originated from the researcher experience and also from interviews with professionals from the field of Psychology. Authors like Freud, Winnicott and Roussillon were mentioned in order to give a better understanding to the main topics researched, such as the emergence of anguish, the avoidance of the traumatic and the possibilities of symbolization. In addition, this research also intends to show the importance of a care and listening that are not necessarily exclusive to the psychoanalyst. This knowledge may be used by other professionals who work in emergency units in benefit of the patient and his/her relatives
A presença do psicanalista no pronto-socorro hospitalar ainda suscita indagações acerca do que pode fazer tal profissional nesse local. Este estudo busca compreender quais são as possibilidades de atuação para o psicanalista em um serviço de urgência e emergência, considerando-se os impasses que esse profissional poderá encontrar nesse ambiente ao trabalhar segundo uma ética e olhar específicos. Trata-se de pesquisa qualitativa fundamentada em uma reflexão teórica realizada a partir de uma leitura psicanalítica e que teve como base empírica vinhetas originárias de experiências da pesquisadora e de profissionais de Psicologia entrevistados. Autores como Freud, Winnicott e Roussillon são utilizados para a compreensão de temas caros à pesquisa, tais como a emergência da angústia, a evitação do traumático e as possibilidades de simbolização. Visa-se ainda contribuir para a valorização de uma escuta e cuidado que não são necessariamente exclusivos do psicanalista. Dessa forma, podem ser utilizados também pelos demais profissionais que trabalham em prontos-socorros em prol do paciente e de seu familiar

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Ball, Colleen. "Homebirth in WA: Why women make this choice." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1277.

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Background: Homebirths in Western Australia (WA) account for approximately 0.8% of all births. Two consecutive reports from the Perinatal and Infant Mortality Monitoring Committee found increased rates of perinatal mortality in homebirths and recommended a prospective cohort study to assess mortality and morbidity outcomes for women with planned home births in WA. The Homebirth in WA Study, of which this thesis is a component, has been funded by a directed research grant. Aim: The aim of this study was to explore the specific reasons why women in WA choose homebirth. Research on homebirths is focused on perinatal outcomes and comparisons of satisfaction between hospital and homebirth. Based on these comparisons, assumptions are made as to why women choose to have a homebirth or make this choice. There is a paucity of research directly addressing the reasons why women make this choice. Methods: This is a quantitative prospective observational study. Pregnant women planning a homebirth in WA were invited to participate in the study. Women recruited into this study (n=135) were asked about their obstetric history and associated satisfaction with their previous birth experience, and were asked to select from any of 27 options as being their reasons for choosing homebirth, with the option to provide additional reasons of their own. They were also asked to select the three most important reasons. Women were asked to rank their perception of how important it is for them to have a homebirth, their perception of the safety, their level of confidence and the support they have received from their spouse and family and friends for their choice. The women were also invited to share further comments. Results: The majority of women (n=107) received care from the Community Midwifery Program and the remainder (n=28) from privately practicing Midwives. In this study 50 women were nulliparous and 85 multiparous. Women who previously had a homebirth reported a higher level of satisfaction (4.7/5) for the birth experience, compared to women who had hospital births (2.3/5). Avoiding unnecessary intervention was the dominan reason for choosing home birth in 95.5% of participants, regardless of parity, education or previous birth experience; this was followed by the comfort and familiarity of the home (93%) and the freedom to make their own choices (86%). Avoiding unnecessary intervention ranked the highest of the 3 most important reasons. Women reported a high level of support for their choice from their spouse (4.65/5) and substantially less from family and friends (3.68/5). They ranked the safety of homebirth highly and had a high level of confidence. The women who elected to share further comments referred most frequently (28%) to GP’s and obstetricians not presenting homebirth as an option, and also made frequent reference to their negative attitude in relation to the women’s choice. Women also commented on the negative attitudes encountered from family and friends, and additional references reflected their attitudes regarding intervention. Conclusion: Women choosing homebirth in WA do so to avoid unnecessary intervention and have the freedom to make their own choices in the surrounds of the home. They receive limited support for their choice from GP’s and obstetricians as well as friends and relatives. This study underscores the reaction of some women to the current rates of obstetric intervention.

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McGarry, Sarah. "Pediatric medical traumatic stress : the impact on children, parents and staff." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/605.

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Burns are one of the most painful and traumatising injuries an individual can sustain and constitute a serious global health threat to children. Despite the magnitude of this public health problem, little research has examined the psychological burden of these injuries. This study used a mixed-methods approach to investigate the effect of paediatric medical trauma on children who have sustained a burn, their parents and the healthcare professionals caring for these patients. The paediatric medical traumatic stress model provided a theoretical framework for this study. Firstly, this study aimed to gain an understanding of the lived experience of children who sustain a burn. Using phenomenology as a methodology, the first paper in this thesis provided an in-depth understanding of children’s perceptions, thoughts and feelings about the lived experience of sustaining a burn. The findings identified two phases of trauma that are central to the burn experience. The paper found that children experience ongoing trauma in addition to the initial trauma of sustaining the burn, resulting in a cumulative trauma experience. Six themes were identified in the data describing the child’s experience: ongoing recurrent trauma; return to normal activities; behavioural changes; scarring-the permanent reminder; family functioning and adaptation. The methodology of this research provided a voice for the child’s perspective of the burn experience and the findings can be used to inform clinical care at all stages of the burn journey. The second paper, a cross-sectional study, aimed to investigate the impact of exposure to paediatric trauma on parents of children with a burn and to identify risk factors and relationships between psychological distress and resilience. The results indicated that parents experienced significantly more symptoms of post-traumatic stress disorder than a comparative population. Factors including having a daughter, witnessing the event, feeling helpless or having past traumatic experiences significantly influenced symptoms of psychological distress and resilience. Findings from this study highlight that health professionals should screen parents to identify those at greatest risk and provide effective evidence-based interventions aimed at improving resilience and reducing stress, as part of standard, routine care. The aim of the third paper was to gain an understanding of the lived experience of parents of a child with a burn injury. Using a phenomenological, qualitative methodology allowed aspects of the parents’ experience not collected in standardised outcome measures to be identified, enabling triangulation with the quantitative results found in the second study. The findings demonstrated that the experience of parents reflected a journey that was represented by three phases: the event, the inpatient phase and the return to the community. Within the three phases, themes of external stressors, emotional and behavioural responses and coping strategies were identified. These findings can be used for the development of protocols to underpin a comprehensive information and social support management plan for families. This would complement the surgical and medical treatment plan, providing direction for comprehensive service delivery. Children, parents and health professionals are interconnected in a professional relationship. The aim of the fourth paper was to investigate the effect of exposure to paediatric medical trauma on multidisciplinary teams and the relationships between psychological distress, resilience and coping skills. Health professionals experienced significantly more symptoms of psychological distress and less resilience than comparative groups. Non-productive coping was associated with adverse psychological outcomes and younger health professionals were more vulnerable to psychological distress than those aged 25 years and above. Findings from this study may assist in developing organisational systems to facilitate optimal mental health and coping strategies in health professionals, with the aim of the maintenance of a healthy workforce. Overall findings from this research provide evidence for health professionals to optimise a holistic clinical service at all stages of the burn journey. These findings provide previously unknown knowledge about the impact of paediatric medical trauma on children, parents and health professionals within a paediatric hospital.

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Director, Dana L. "The Impacts of Change in Governance on Faculty and Staff at Higher Education Institutions: A Case Study of OHSU." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1490.

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In the early 1990s, Oregon Health and Science University leadership examined the political and economic landscape and determined it needed a new operational model to survive and thrive. In 1995 OHSU separated from the state higher education system and became a public corporation, with goals of increased efficiency, customer-focus, ability to attract world-class researchers and physicians, and salaries commensurate with an urban academic health center. This research examines the internal impacts when universities undergo significant change, using OHSU's governance change as a case study. Central is the question: what effect(s) did OHSU's decision to become a unique public corporation have on specific employee groups? This study looks at two groups and their perceptions of the change: faculty, and union-represented staff. The author interviewed the leadership team who led the transition, reviewed historical and organizational documents and archives, and examined quantitative data such as tuition, state funding, research, and salaries. Interviews were then conducted with longtime and former employees to obtain employee perceptions. Finally, the study compares employee perceptions about process, culture, and job satisfaction, to the goals established by the leadership. The results of this study reveal that, while there were internal and external challenges, the transition to a public corporation was successful according to the perceptions of most employees when compared to the goals. After the transition, OHSU did become more efficient and more nimble for a time, able to recruit world-class employees and pay competitive salaries. Staff felt empowered and some faculty felt it made OHSU a better institution. However, some faculty felt that OHSU's transition to the public corporation eventually led to increased bureaucracy, as well as to the loss of shared governance, tenure practices, and other cultural norms inherent to academic institutions. By examining OHSU's transition and the impacts on employee groups, this study provides insight to other universities contemplating this type of change. While each institution is unique, understanding the impacts to these key stakeholders can help universities plan for and implement significant governance change.

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Munro, Susan 1938. "The education of the health care professional in terminal care in the light of the emotional impact of the nature of the work /." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65973.

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Fouche, Jean-Paul. "A diffusion tensor imaging study in HIV patients with and without apathy." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5146.

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Thesis (MScMedSc (Biomedical Sciences. Medical Physiology))--University of Stellenbosch, 2010.
ENGLISH ABSTRACT: HIV/AIDS is a global epidemic that accounts for a large percentage of the mortality in South Africa every year. Since the implementation of anti-retroviral treatment, HIV positive individuals have been living longer, and the cognitive impairment associated with the disease is becoming increasingly apparent. During the initial systemic infection of HIV, the virus migrates through the blood-brain barrier and inflicts axonal injury by causing upregulation of cytokines and neurotoxic proteins. HIV-associated dementia is a neuropsychological classification of cognitive impairment in HIV and a variety of symptoms have been classified as a part of the dementia complex. One of these is apathy, which is thought to be a precursor for dementia in HIV patients. Three groups of individuals have been recruited and scanned using magnetic resonance imaging (MRI) to examine changes in the brain. These are an HIV non-apathetic cohort, an HIV apathetic cohort and a healthy control cohort. Diffusion tensor imaging (DTI) is an MRI technique used to quantitatively assess white matter (WM) integrity using metrics such as fractional anisotropy (FA). Voxel-based analysis, tract-based spatial statistics (TBSS) and tractography are three established DTI analysis methods that have been applied in numerous studies. However, there are certain methodological strengths and limitations associated with each technique and therefore all three of these techniques were used to compare WM differences across groups. The frontal-subcortical pathways are known to be abnormal in apathy, and this has been demonstrated in a number of imaging studies. Most of these studies have examined apathy in the context of neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s. However, to our knowledge this is the first DTI study in HIV apathetic patients. With the tractography method, the anterior thalamic radiation and the corpus callosum were reconstructed for each individual to determine whether there were any global changes in these tracts. No significant changes were found. However, a variety of regions in the WM were significantly abnormal in the HIV cohorts when comparing the data at a voxel-based level and using TBSS. This included areas such as the genu and splenium of the corpus callosum, the internal capsule and corona radiata. Changes in frontal WM for the HIV apathy group are an indication of dysfunction in the frontal-striatal circuits, and previous literature has implicated these circuits in the neuropathology of apathy in a variety of central nervous system (CNS) disorders.
AFRIKAANSE OPSOMMING: MIV/VIGS is `n wêreldwye epidemie wat verantwoordelik is vir `n hoë sterftesyfer in Suid- Afrika elke jaar. Sedert die inleiding van anti-retrovirale behandeling, het die MIV-positiewe populasie se lewensduur verleng. Tesame met langer lewensduur, het die kognitiewe verswakking wat geassosieer word met die siekte ook meer prominent na vore gekom. Gedurende die beginstadium van sistemiese infeksie in MIV is daar `n migrasie van die virus deur die bloed-breinskans. MIV kan indirek verantwoordelik wees vir aksonale beskadiging deur verhoging van neurotoksiese proteine en sitokinien te induseer. MIV-geassosieerde demensie is `n neurosielkundige klassifikasie van kognitiewe verswakking in MIV en verskeie simptome is al geïdentifiseer as deel van die demensie kompleks. Een van die simptome is apatie en daar word gespekuleer dat dit `n voorloper is vir demensie in MIV pasiënte. Drie groepe individue was gewerf vir die studie en geskandeer deur magnetiese resonansie beeldvorming (MRB) om sodoende veranderinge in die brein te ondersoek. Die groepe was onderskeidelik `n HIV nie-apatiese kohort, `n HIV apatiese kohort en `n gesonde kontrole kohort. Diffusie tensor beelding (DTB) is `n MRB tegniek wat toegepas word om witstof integriteit te meet deur gebruik te maak van maatstawwe soos fraksionele anisotropie (FA). “Voxel-based analysis”, “tract-based spatial statistics (TBSS)” en “tractography” is drie gevestigde DTB analitiese metodes wat al in talle studies toegepas was. Daar is egter sekere metodologiese voordele en beperkings verbonde aan elke tegniek en daarom is al drie tegnieke gebruik om witstof verskille tussen groepe te vergelyk. Die frontale-subkortikale roetes in die brein is bekend vir abnormaliteite in apatie en dit was ook al gedemonstreer in verskeie studies. Die meeste van die studies het apatie ondersoek in die konteks van neurodegeneratiewe siektes soos Alzheimer se siekte en Parkinson se siekte. Maar sover ons weet is hierdie die eerste DTB studie in MIV pasiënte met apatie. Met die “tractography” metode was die anterior thalamic radiation en corpus callosum herbou vir elke individu. Dit was om te bepaal of daar enige globale veranderinge is in hierdie gebiede, maar geen beduidende veranderinge is gevind nie.`n Verskeidenheid van gebiede in die witstof was beduidend abnormaal in die MIV kohorte wanneer die data vergelyk was met “TBSS” en “voxel-based analysis.” Dit het gebiede ingesluit soos die genu en splenium van die corpus callosum, die internal capsule en die corona radiata. Veranderinge in die frontale witstof vir die MIVapatie groep is `n aanduiding van disfunksie in die frontale-striatale bane. Vorige literatuur impliseer dat hierdie bane betrokke is in die neuro-patologie van apatie in verskeie sentrale senuweestelsel (SS) steurings.

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Fillion, Jennifer Mary. "Metaphor Use in Interpersonal Communication of Body Perception in the Context of Breast Cancer." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1014.

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Female breast cancer patients are often confused, frustrated, and devastated by changes occurring in their bodies and the treatment process. Many women express frustration and concern with the inability to know what the next phases of their life will bring. Previous research also states that many women struggle to communicate with others about treatment as well as side effects. This research examined how woman are use metaphors to describe their experience with breast cancer, specifically throughout the treatment period related to body image struggles. I qualitatively conducted interviews with women who were either currently in treatment or just finishing. My interview questions related to their uncertainties, as well as the changes occurring to their bodies. After conducting the interviews I transcribed the conversations and coded for specific metaphors. The results were consistent with previous research, in that that the interviewees used at least four major metaphors to describe what they are going through. The four most prominent metaphors were (1) journey, (2) game, (3) struggle/fight, (4) grasping. The findings could benefit patients, nurses, physicians as well as family and friends to reduce stress and help with coping. The findings may also help female patients struggling with identity issues due to lumpectomies or mastectomies. Understanding how patients comprehend the disease can ultimately help others to understand and hopefully reduce some of the concerns of all those involved in such situations.

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O'Driscoll, Catherine T. "A study to determine the quality of life and experiences for liver and kidney transplant recipients and living kidney donors in Western Australia : the economic implications." University of Western Australia. School of Surgery, 2008. http://theses.library.uwa.edu.au/adt-WU2009.0077.

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The use of quality-of-life as an outcome measure provides detailed information about the effectiveness of medical treatments than morbidity or mortality rates alone. The use of quality-of-life data in the clinical setting can inform patients regarding treatment options, treatment benefits and costs. In competing health care markets, outcome measurement is regarded as important as it is concerned with the impact of health care practice and affects health policy decisions. Doessel (1978) conducted the first Australian study on the cost-effectiveness analysis of renal replacement therapies. The study was based on Klarman, Francis & Rosenthal's (1968) the study, where the output was measured in terms of the number of life years gained from kidney transplantation, and a twenty-five percent weight was allocated in an attempt to capture quality-of-life from kidney transplantation. Doessel (1978) used two sources of data: Australian data (Disney 1974) and European data (Gurland et al. 1973; Shiel et al. 1974). The study measured life years gained, and agreed with the Klarman et al. (1974) findings that transplantation is the most effective way to increase life expectancy of persons with chronic renal disease (Butler & Doessel 1989). The outputs of the alternative treatments were not reported in monetary terms; the study focused on life years gained as the output measure. Hence the importance of this current study, which includes a cost-effectiveness analysis for cadaver liver, and living kidney transplantation for end-stage liver and kidney disease patients. Calls to respect patient autonomy and to produce patient-centered outcomes have recently brought the patients point of view back into the center of clinical medicine (Sullivan 2003). Survival rates indicate one measure of outcome however they do not reflect patients perceptions of health benefit or experiences. Noting that patients psychosocial effect on functioning is of more concern to them than their physical Thesis Preamble iii ability, that more accurate knowledge of patients conditions be measured prior to transplantation (Tarter et al. 1991). Recently researchers advocated investigating transplant patients' states of health to assess the social benefit of these expensive health care services from their perspective (Joralemon & Fujinaga 1997). The current study's mixed method, bridges the gaps in treatment outcome measurements, as the mixed method applied (Creswell 1994; Sim & Sharp 1998) prospectively measured quality-oflife, determined health utility, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The study reported the living donors experience of the donation process, described their needs; expressed using a new psychosocial model supporting future living kidney donor's during the donation process.

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Singh, Shail. "The effects of perceived discrimination on Samoan health." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3260.

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The purpose of this study was to examine the effect of perceived discrimination on Samoan health. This study employed purposive data collection and was conducted quantitatively using a questionnaire format, which measured everyday perceived discrimination, depression, and physical health.

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Gnanadev, Appannagari M. D. "Expanding a gang tattoo removal program for San Bernardino County." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1738.

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This thesis covers the background and history of cultural attitudes towards body art, scarification and tattoos, the history of street gangs and their influence and impact on Southern California communities, and an in-depth program analysis of the "Gang Tattoo Removal Program" established at the Arrowhead Regional Medical Center (ARMC).

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Panidi, Ksenia. "Essays to the application of behavioral economic concepts to the analysis of health behavior." Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209674.

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In this thesis I apply the concepts of Behavioral Economics to the analysis of the individual health care behavior. In the first chapter I provide a theoretical explanation of the link between loss aversion and health anxiety leading to infrequent preventive testing. In the second chapter I analyze this link empirically based on the general population questionnaire study. In the third chapter I theoretically explore the effects of motivational crowding-in and crowding-out induced by external or self-rewards for the self-control involving tasks such as weight loss or smoking cessation.

Understanding psychological factors behind the reluctance to use preventive testing is a significant step towards a more efficient health care policy. Some people visit doctors very rarely because of a fear to receive negative results of medical inspection, others prefer to resort to medical services in order to prevent any diseases. Recent research in the field of Behavioral Economics suggests that human's preferences may be significantly influenced by the choice of a reference point. In the first chapter I study the link between loss aversion and the frequently observed tendency to avoid useful but negative information (the ostrich effect) in the context of preventive health care choices. I consider a model with reference-dependent utility that allows to characterize how people choose their health care strategy, namely, the frequency of preventive checkups. In this model an individual lives for two periods and faces a trade-off. She makes a choice between delaying testing until the second period with the risk of a more costly treatment in the future, or learning a possibly unpleasant diagnosis today, that implies an emotional loss but prevents an illness from further development. The model shows that high loss aversion decreases the frequency of preventive testing due to the fear of a bad diagnosis. Moreover, I show that under certain conditions increasing risk of illness discourages testing.

In the second chapter I provide empirical support for the model predictions. I use a questionnaire study of a representative sample of the Dutch population to measure variables such as loss aversion, testing frequency and subjective risk. I consider the undiagnosed non-symptomatic population and concentrate on medical tests for four illnesses that include hypertension, diabetes, chronic lung disease and cancer. To measure loss aversion I employ a sequence of lottery questions formulated in terms of gains and losses of life years with respect to the current subjective life expectancy. To relate this measure of loss aversion to the testing frequency I use a two-part modeling approach. This approach distinguishes between the likelihood of participation in testing and the frequency of tests for those who decided to participate. The main findings confirm that loss aversion, as measured by lottery choices in terms of life expectancy, is significantly and negatively associated with the decision to participate in preventive testing for hypertension, diabetes and lung disease. Higher loss aversion also leads to lower frequency of self-tests for cancer among women. The effect is more pronounced in magnitude for people with higher subjective risk of illness.

In the third chapter I explore the phenomena of crowding-out and crowding-in of motivation to exercise self-control. Various health care choices, such as keeping a diet, reducing sugar consumption (e.g. in case of diabetes) or abstaining from smoking, require costly self-control efforts. I study the long-run and short-run influence of external and self-rewards offered to stimulate self-control. In particular, I develop a theoretical model based on the combination of the dual-self approach to the analysis of the time-inconsistency problem with the principal-agent framework. I show that the psychological property of disappointment aversion (represented as loss aversion with respect to the expected outcome) helps to explain the differences in the effects of rewards when a person does not perfectly know her self-control costs. The model is based on two main assumptions. First, a person learns her abstention costs only if she exerts effort. Second, observing high abstention costs brings disutility due to disappointment (loss) aversion. The model shows that in the absence of external reward an individual will exercise self-control only when her confidence in successful abstention is high enough. However, observing high abstention costs will discourage the individual from exerting effort in the second period, i.e. will lead to the crowding-out of motivation. On the contrary, choosing zero effort in period 1 does not reveal the self-control costs. Hence, this preserves the person's self-confidence helping her to abstain in the second period. Such crowding-in of motivation is observed for the intermediate level of self-confidence. I compare this situation to the case when an external reward is offered in the first period. The model shows that given a sufficiently low self-confidence external reward may lead to abstention in both periods. At the same time, without it a person would not abstain in any period. However, for an intermediate self-confidence, external reward may lead to the crowding-out of motivation. For the same level of self-confidence, the absence of such reward may cause crowding-in. Overall, the model generates testable predictions and helps to explain contradictory empirical findings on the motivational effects of different types of rewards.
Doctorat en Sciences économiques et de gestion
info:eu-repo/semantics/nonPublished

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Beaton, Deborah, and University of Lethbridge Faculty of Education. "Long-term implications of critical incident stress among emergency responders." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 2003, 2003. http://hdl.handle.net/10133/201.

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Critical Incident Stress has the potential to affect emergency services personnel to the degree that it can change the way the responder acts and reacts in all facets of his or her life, including the job and his or her family. Research into these potential effects has produced a greater understanding of the responders experiences within a short period of time after the perceived critical incident. This study investigates the long-term effects of critical incident stress among emergency responders from two cities in the three emergency services professions were interviewed to determine what their experiences were at least six months post critical incident. A structured incident had in three areas of teh emergency responders lives: impact on job, impact on the individual responder, and perceived impact on emergency responders families. For particpants, symptoms of Critical Incident Stress lasted between 6 months and 2 years after the perceived critical incident. Analysis of the data indicatees that single responder critical incidents have the potential to negatively affect emergency responders resulting in the loss of enthusiasm and passion for their work, debilitating psychological distress, and isolation from valued support systems. Long-term effects of Critical Incident Stress change the perceptions that responders have about the job, about themselves, and the relationships with their families. The culture of emergency services, changing identities, and the lack of support from both within the system and outside of the system were seen as variables that contribute to the long-term effects of Critical Incident Stress.
xi, 181 leaves ; 29 cm.

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Dubois, Sylvie. "The role of informational support in relation to health care service use among individuals newly diagnosed with cancer /." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=115895.

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Background: The relationship between informational support and use of health care services among individuals newly diagnosed with cancer remains little documented despite its importance for optimal care delivery. Aim: To document the role of informational support in light of patterns of health services used by women and men newly diagnosed with cancer. Method: A sequential mixed methods approach (i.e., quantitative-qualitative) was conducted among women and men newly diagnosed with either breast or prostate cancer. First, an existing quantitative database was used to determine whether an intervention relying on multimedia tool as a complement to the provision of usual cancer informational support to patients (N = 250) would modify subsequent health care service use. A follow-up qualitative inquiry with distinct individuals also newly diagnosed (N = 20) was conducted to explore this relationship further. Next, the resulting quantitative and qualitative findings were merged and reanalyzed using a quantitative-hierarchical approach to enhance our understanding of the phenomenon. Findings: Several personal and contextual factors were found to qualify the relationship between cancer informational support and health service use. Although quantitative analyses showed no significant differences in terms of overall reliance on health care services among participants who received more intense cancer informational support as opposed to those who received care as usual, several sex differences were noted in terms of number of visits to health care professionals, time spent with nurses and satisfaction with cancer information received. Qualitative findings revealed that participants reported a variety of experiences pertaining to cancer information received (e.g., positive, unsupportive or mixed) as well as several processes at play (e.g., cancer information seen as enabling, confirming, or conflicting). These differences in informational support, in turn, influenced their subsequent service utilization (e.g., more phone calls made to health professionals, reduction in face-to-face visits, reluctance to use cancer-related services). The mixed data analysis clarified further the findings allowing a broader perspective to emerge. Conclusion: Findings underscore that the relationship between cancer information and use of services is not as straightforward as initially anticipated. These findings provide initial insights that may inform future research on the topic and assist health care providers in optimizing their cancer informational interventions to guide patients in their reliance on health care services.

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Osmancevic, Himka. "A brief screening instrument for use by lawyers to assess the capacity of older clients with memory deficits." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/336.

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The number of people in Australia and around the world is increasing rapidly, particularly people over the age of 65. As part of the aging process, cases of dementia. cognitive impairment and mental iIIness become more prevalent. The issue of competence in this population has become more significant in recent years . Older people frequently face decisions that require the consultation of a lawyer, such as issues over wills and financial investments. Preventative law advocate lawyers act as therapeutic agents, preventing stress and discomfort in elderly clients making legal decisions. In order for practising lawyers to act as therapeutic agents, an ability to detect impaired decision making capacity in older adults is required. The present study explores this issue further.

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Modiba, Lebitsi Maud. "Support programme for mothers with pregnancy loss." Thesis, 2012. http://hdl.handle.net/10210/6847.

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D.Cur.
Although the general topic of death is receiving increasing attention by the medical community, little is known about the impact that pregnancy loss has on the lives experiencing it. Statistics show that the problem is widespread, but they tell nothing about the tears, the regrets, the feeling of guilt and the long process of rebuilding hope. And the medical community is not consistent in attitude or skill where caring for mothers with pregnancy loss. Mothers expect their physicians to be understanding and compassionate, especially when the worst fear has become a reality and the baby had died. Sadly, these expectations are too often unfulfilled, leaving the mother angry and confused, instead, death becomes the enemy to be avoided and opposed at all costs. The purpose of this study is to develop a conceptual framework of support to mothers with pregnancy loss to assist midwives and doctors in supporting these mothers

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Vawda, Naseema B. M. "Perceived stress, coping behaviour, and health outcomes among South African undergraduate medical students." Thesis, 2003. http://hdl.handle.net/10413/7931.

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This empirical study assessed the perceived stressors in medical school environment and psychological outcomes in undergraduate medical students in a non - western sample. The sample consisted of African and Indian students in the Clinical group (N = 149) and a matched Control group, the Pre-clinical group (N = 158) bringing the total number of participants to 307. The research dealt with perceived stressors, coping mechanisms and outcomes in a medical school environment. Outcome was assessed using self-report instruments which examined stress symptoms and psychological distress. Both bivariate and multivariate correlational analyses were performed to investigate correlations and the predictive value of risk factors for psychological distress. The findings indicate that there are no significant differences in the perception of stressors in the medical school environment between the Pre-clinical and Clinical groups. Maladaptive coping strategies, perceived stressors and female gender have important roles to play in predicting psychological distress. High self-esteem and good social support for both groups, as well as optimism in the Clinical group protects against psychological distress. Strengths and limitations of this study as well as implications for intervention strategies among undergraduate medical students are also discussed.
Thesis (Ph.D.)-University of KwaZulu-Natal, 2003.

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Dissertations / Theses on the topic 'Medical referral Psychological aspects'

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