Dissertations / Theses on the topic 'Palliative treatment Study and teaching'
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Watts, Tessa Elisabeth. "Educating undergraduate pre-registration nursing students for complexity in contemporary palliative nursing." Thesis, Swansea University, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678375.
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Gentry, W. Michael. "A comparison of two palliative methods of intervention for the treatment of mathematics anxiety among female college students." Diss., Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/53620.
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Bandura’s (1978) self-efficacy theory provided the conceptual basis for two math-anxiety interventions: cognitive restructuring (CR) and modified progressive relaxation (MPR). These two palliative techniques were chosen since considerable evidence exists which indicates that both intrapsychic and symptom-directed methods are effective as therapeutic interventions for a wide range of stress-related problems. In addition to the treatment variable, there were two other independent variables: level of achievement in mathematics (SAT), and level of participation in mathematics (remedial, intermediate, or advanced). The sample consisted of sixty—two female subjects enrolled in a small private liberal arts college for women. Four research questions were investigated (1) When administered over a six-week treatment period, are CR and MPR equally effective in reducing mathematics anxiety among female college students? (2) Are any combinations of treatment and level of achievement in mathematics characterized by lower levels of anxiety than other combinations? (3) Are any combinations of treatment and level of participation in mathematics characterized by lower levels of anxiety than other combinations? (4) To what extent do physiological indicators of mathematics anxiety and paper-and-pencil assessments measure the same construct?
Data were collected in two stages. The first stage occurred at the end of a six-week treatment period, at which time Sandman’s (1973) Mathematics Attitude Inventory (MAI) and an electromyograph (EMG) were used to obtain self-report and physiological measures of mathematics anxiety, respectively. The second stage occurred eight weeks later, at which time the MAI was re-administered. Inferential methods revealed that: (1) when mathematics anxiety was measured with Sandman’s MAI, for both the immediate and delayed posttests, the difference between the mean levels of self-reported anxiety for CR and MPR subjects was not statistically discernible; (2) when anxiety was operationally defined as skeletal muscle tension and measured with an electromyograph, CR led to significantly greater reductions in anxiety than MPR (F=2.81, p=.036); (3) there was no interaction between type of intervention and level of achievement in mathematics; (4) when anxiety was operationally defined as skeletal muscle tension and measured with an electromyograph, a statistically discernible (F=3.925, p=.O27) synergistic effect was detected between type of intervention and level of participation in mathematics, indicating that CR is superior to MPR for subjects at advanced levels of participation in mathematics; (5) there was insufficient evidence to indicate that a linear relationship exists between paper-and-pencil (MAI) and physiological (EMG) measures of mathematics anxiety, implying that the two instruments may be tapping different dimensions of the mathematics anxiety construct.Ed. D.
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Terkildsen, Sheryl Ramona. "End of life nursing education consortium grant implementation project." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2324.
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This project addressed the continuing education needs of nursing staff and other health care professionals for delivering competent and compassionate palliative or end of life care. The scope of the project included, writing a grant application, training and certification by the end of life Nursing Education Consortium and implementing an education program for staff at the Loma Linda Veterans Affairs medical center.
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Greaves, Judith M. "Understanding palliative care: An ethnographic study of three Australian palliative care services." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2005. https://ro.ecu.edu.au/theses/1553.
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Palliative care commenced in Australia in the early 1980s. Although the value of palliative care has become more widely recognised by the public and other health care professionals, there is still a lack of understanding about what palliative care is and the depth and scope of this specialty area of health care. The research that I present in this thesis is based on examination of palliative care practice in a selection of Australian services, undertaken with the aim of enhancing understanding of Palliative Care. The significance of the research arises from the notion that members of the Australian community should be well informed about health care options available to them. Understanding palliative care and the ability to differentiate palliative care from other end-of-life care is important if people are to make informed decisions about supporting, accessing, and using services appropriate to their needs. An interpretive ethnographic study from a symbolic interactionist perspective was undertaken in three palliative care services, one in each of the major Australian cities of Sydney. Melbourne, and Perth. Each palliative care service had been established for at least ten years, and was part of a larger health care facility. A fourth service, a purpose-built three-year-old unit, was added during the course of the research to provide contrast to the emerging analyses. As an experienced palliative care nurse, I assumed the role of marginal native as the primary research instrument. Data collection was by means of participant observation, formal and informal interviews, and examination of supplementary data sources, with two months spent in each of the three study sites. Interpretations made from ethnographic observation of these Australian palliative care services showed a diversity of practice, best understood within the context of the particular service. The major findings are presented under the headings of Politics, Place, People, and Practice of Palliative Care. Common approaches to provision of care were found in creating an appropriate physical environment for patients, with an underlying mission to "make the best of things." Patients cared for in the settings were a similar cohort of middle aged to elderly cancer patients. In general, staff shared expectations of appropriate types of patients and showed discomfort or lack of understanding in caring for non-cancer patients, or patients from non-Australian, non-Christian, and non-English speaking backgrounds. Practice diversity was highlighted by the range of technology used and variations in the availability of social activities for patients in the services. These two: areas in particular warrant further research to examine the outcomes associated with these variations, in terms of survival time, quality of life, and service costs.
These findings are particularly relevant at this time when the Australian Government is attempting to enhance access to palliative care. The diversity of practice uncovered in this study suggests that discussions and decisions about allocation of resources and development of services must take into consideration the various interpretations of palliative care services that may exist. The findings also reinforce the need for sound evidence-based studies to examine the impact of variations and the types of populations that might be best served by different types of palliative care support.
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McConigley, Ruth. "Rural palliative care nursing: A modified grounded theory study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/986.
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This paper presents the findings of a study of rural palliative care nurses in Western Australia. The numbers of rural centres in Western Australia offering palliative care services are increasing; however at present there is little empirical data available about the roles of the nurses involved. This study was undertaken to begin to correct this deficit. The study examines basic social processes associated with the role of rural palliative care nurses and identities issues that affect the nurses’ professional practice. A modified grounded theory approach was used to form a conceptual framework that describes rural palliative care nursing. Theoretical sampling techniques were used to identify the six palliative care nurses working in rural Western Australia who participated in this study. Data was generated using in depth interview and participant observation techniques. Constant comparative analysis of the data was employed to allow concepts to emerge from the data. The central theme that developed from the data Living Palliative Care describes the all-consuming nature of the rural palliative care nurses’ role. Three related categories, Wearing Many Huts, Being the Expert and Surviving in Palliative Care are also discussed. This research has explored issues that rural palliative care nurses feel are relevant to their professional practice and it describes the basic social processes inherent in the rural palliative care nurse’s role. Recommendations for nursing research, education, administration and clinical practice are presented.
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Hill, Hazel Catherine. "Psychosocial support within the everyday work of hospice ward nurses : an observational study." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/24356.
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Psychosocial support is said to be an inherent component of nursing care and a major focus of palliative care. Literature exists which outlines perceptions of the psychosocial needs of patients and how psychosocial support should be provided. However, there is a lack of empirical evidence on how psychosocial support is operationalised in practice. This study provides a valuable and substantial new contribution to the evidence on the psychosocial needs expressed by patients in a hospice ward and how nurses immediately respond to these needs within their everyday practice. A study gathering data via observations with matched interviews of patients and nurses, organisational, documentary, and demographic variables, was conducted over an eight month period. Thirty-eight nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data was analysed using constant comparative qualitative techniques. Patients expressed a wide variety of psychosocial needs, often only signalling them whilst receiving care for other reasons. Considering these needs in relation to Maslow’s (1943) hierarchy of needs suggests that in-patients more commonly express prerequisites to physiological care and ‘lower level’ safety needs rather than the more thoroughly researched and espoused ‘higher’ level psychosocial needs. The nurses reacted to these psychosocial needs with a range of responses which indicated a diminishing level of immediate support: ‘dealing’, ‘deferring’, ‘diverting’ and ‘ducking’. The majority of the nurses were observed using each of these responses at some point during data collection. A variety of the responses were used for each type and context of psychosocial need. These responses were influenced by the ward’s workplace culture. This study demonstrates a requirement for more thorough consideration of the true psychosocial needs of patients, which appear to vary dependent on the context of care. Consideration should be v given to workplace culture and its influence over psychosocial support, with nurses being supported to expand their response repertoire so that patients’ psychosocial needs are acknowledged more. Increasing nurses’ knowledge of the reality of psychosocial support through education and research will encourage formalisation of the place of psychosocial support in the planning, documentation and provision of care. This study shows that ward nurses can offer psychosocial support as an inherent component of their everyday work. Findings derived from this research indicate that developing an understanding of how patients express psychosocial needs in practice, through a consideration of Maslow’s (1943) hierarchy of needs, may increase recognition and support of psychosocial needs and enable nurses to respond more comprehensively.
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Tanner, Carolyn A. "Perception of palliative care practice of health care professionals in a mental institution : a descriptive study." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/29703.
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The purpose of this descriptive study is to investigate the perception of practice of health care professionals at a mental institution, as it pertains to their work with dying patients, and also to identify areas of change. The conceptual framework is constructed of six factors important to palliative care that have been identified from the literature. These are personal death anxiety, organizational structure of the hospital system, role expectations of professionals, teamwork, education and training for care of the dying, and conveyance and exchange of diagnostic information. The sample surveyed by a written questionnaire included physicians, psychiatrists, health care workers, social workers and pastoral care workers from the Geriatric Division of Riverview Hospital, Port Coquitlam. The findings indicate that age, sex, marital status and length of working experience at Riverview Hospital had no significant association with personal death anxiety. Informal education such as workshops and in-services had a significant correlation with personal death anxiety, as did perception of being competent and/or confident about working with the dying. The study also raised concerns that not all was being done for the dying patients and their families at this institution. Suggestions such as education and training, support mechanisms, and less stereotyping of professional roles were
offered to improve this situation. As well, findings indicated that there was a need for palliative care service either in the form of a team or separate unit, or simply the practicing of the palliative care philosophy.Arts, Faculty of
Social Work, School of
Graduate
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Reid, Noreen. "An action research study to investigate the strategies that can be used by health care professionals, during video consultations with palliative care patients, to enhance the therapeutic alliance." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27690.
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Background: The use of telemedicine was gaining momentum. Although the strength of the therapeutic alliance (TA) correlated with treatment outcomes, there was no research exploring the skills, attitudes and behaviours that enhanced the TA during Skype consultations in palliative care. Aims: This study identified the skills, attitudes and behaviours that affected the TA between palliative care patients and health care professionals during Skype consultations and identified strategies that enhanced the TA. Study Design: Two cycles of action research engaged the participants in self-reflective inquiry and encouraged the identification of strategies that enhanced the TA and the Skype experience. Participants: Six health professionals and nine patients were recruited from a Hospice out patient service in one Health Authority in England. Data Collection: Data from the audio-recorded consultation were managed quantitatively and the TA was measured using the Working Alliance Inventory (S). Qualitative data were collected from participant interviews and focus groups attended by the professionals. Data Analysis: The analysis ran in parallel with the data collection, started after the first consultation and all sources of data were cross-referenced. Thematic analysis was used to sequentially code the qualitative data to help identify, examine and record patterns within the data set. Findings: The findings suggested that it was possible to establish and a positive therapeutic alliance between health professionals and palliative care patients when using Skype. There was a shift in perception for those health professionals who had reservations about their ability to establish a therapeutic alliance (TA) via a computer link. It was demonstrated that advanced communication skills were transferrable between face to face and video consultations. No additional communication skills training was needed to enable a strong TA when using Skype. Including some social talk, working with the patient’s as opposed to the professional’s agenda and actively offering solutions improved the Skype experience for the patients. The strategies that health professionals promoted to enhance the TA included using Skype with appropriately selected patients to complement the existing Service. Mandatory training in the effective use of Skype was recommended even for those health professionals who used Skype socially. Clarification to address the challenge of clinical governance was recommended. In keeping with an action research design the change impacted on both the health professionals own practice and the Organisation’s approach to telemedicine. The potential for using action research to engage nurses and doctors in critical self-reflective inquiry and to empower them to be change facilitators was demonstrated. Conclusion: Although a small sample size, this study identified strategies that enhanced the TA during Skype consultations. The findings were significant because they added to the current body of knowledge about using Skype to facilitate consultations within the palliative care population. Additionally, the findings may be transferable to different populations and healthcare contexts.
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Carolan, Clare. "The experience of emotional distress and help-seeking for distress in families living with advanced cancer and receiving palliative care : a multi-perspective case study approach." Thesis, University of Stirling, 2018. http://hdl.handle.net/1893/28047.
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The emotional impact of serious illness in families is recognised. To enhance well-being in families living we must understand how distress is experienced within families; from this, evidenced-based systemic distress interventions can be derived. However, the success of systemic intervention programmes is reliant on whether families will seek help (or not) for distress. This PhD by publication explores emotional distress and help-seeking in families living with advanced cancer. Papers one and two used systematic review techniques. Paper one evidenced distress as a systemic construct and proposes the tiered model of distress to convey current understandings. Paper two offers the attaining normality model to convey why some people seek help for distress to achieve a new normality whereas some choose not to seek help to maintain normality. Together, these papers evidence gaps in systemic understandings of distress and help-seeking; from this an exploratory cross-sectional multiple case study of families was proposed. Papers three and four provided methodological underpinning to this research through the development of the DESCARTE model: The Design of Case Study Research in Healthcare (paper three) used in the case study design; paper four reflects on multi-perspective interviewing methods used. Distress and help-seeking are conceived as systemic relational phenomena, occurring within the family system and arising from relational interaction with healthcare. Distress is conveyed through four themes: interdependent distress, living in uncertainty, unnecessary distress and oscillatory distress; from this, possible systemic intervention designs are offered (paper five). Non-help-seeking for distress was the predominant response in families. The mutuality model of help-seeking is proposed to synthesise current understandings (paper six). Families describe how healthcare interactions cause unnecessary distress and shapes families’ help-seeking behaviours. Findings indicate significant gaps between the rhetoric of palliative care policy and families’ experience. To improve families’ wellbeing, relational care must be embedded in policy and practice.
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Dlangamandla, F. N. N. "A case study of a teacher's oral error treatment strategies in an English language classroom." Thesis, Rhodes University, 1996. http://hdl.handle.net/10962/d1003315.
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Theoretical perspectives on error treatment in second language acquisition research are divided on the effect and desirability of corrective feedback on the learner's output. Theorists like Krashen (1982), believe that correction hampers acquisition because it encourages the learners to avoid difficult structures and to focus on form rather than on meaning, while Long (1977) contends that error treatment possibly speeds up interlanguage development although errors disappear slowly. Edmondson (1985) asserts that bringing errors to the learner's attention helps learning and that error - treatment contributes to consciousness-raising which is important for language acquisition. Research findings present conflicting evidence on the effects of corrective feedback on those for whom correction is meant. Some researchers report no concrete findings on the relationship between corrective feedback and learning outcomes (Hendrickson (1978) and Brock, Day and Long (1986)). Others, for example, Chaudron (1977) and Crookes and Rulon (1985) report differential effects of corrective treatments. Salica, Ramirez and Stromquist and Wren (cited in Chaudron 1988) report some evidence of feedback on error resulting in the learner's ability to self-correct. However, Hendrickson (1978) reports that some direct types of corrective procedures have been found to be ineffective. This research investigated a teacher's oral error treatment policy in different types of English lessons in a situation where L2 pupils study English as a subject according to an LI syllabus. The findings of this case study reveal that the teacher's manner of correction, when he decides to correct, is subtle and indirect. Rarely does he correct overtly and explicitly as his concern is to avoid hurting the error maker's feelings. He defers treatment and ignores most of the oral errors that learners make during classroom interaction. Pupil perceptions of their teacher's corrective treatments were positive although some of the pupils reported that they found his corrections confusing and intimidating at times. Most of them expressed , a wish to have their speech errors attended to explicitly, preferably by their teacher as his treatments were found to be motivational and unabrasive. Some of the pupils were opposed to peer correction for fear of ridicule. They also felt that fellow pupils did not always provide correct treatments. All the pupils in this study were of the opinion that oral error treatment is desirable because they believe that it improves their performance in English.
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Marlow, Susan Anne. "A voyage of grief and beauty: a phenomenological study of the experience of supporting a family member with an intellectual disability who is dying in a community setting : a thesis submitted to the Victoria University of Wellington in partial fulfilment of the requirements for the degree of Master of Arts (Applied) in Nursing /." ResearchArchive@Victoria e-thesis, 2007. http://hdl.handle.net/10063/140.
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Fowler, Philip A. "The longitudinal treatment and structure of plate tectonics in introductory college-level physical geology textbooks : 1974-2005." Virtual Press, 2005. http://liblink.bsu.edu/uhtbin/catkey/1325992.
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The objective of this study was to determine if trends were present in the longitudinal treatment of concepts of plate tectonics in introductory college-level physical geology textbooks. In addition, a method was designed to convey the structure of these concepts of plate tectonics by determining the location in the textbook where they occur.Eighteen textbooks were selected from the time period of 1975 through 2004. The total narrative area was determined by measuring the height and width of each column of text in each textbook. Individual concepts of plate tectonics were determined using the constant comparative method. Nine concepts were identified. The treatment of each concept was expressed as a concept's percentage of the textbook's total narrative area. The structure of plate tectonics in each textbook was determined by creating scatterplots and pie graphs of the location within the text and the area devoted to each concept. Furthermore, a measure of the structure of the textbook over the study period was determined by comparing the proportion of chapters containing concepts of plate tectonics with the publication date.A strong positive correlation (r=.638) was found between the treatment of the theory of plate tectonics and the publication date of the textbook. This correlation was significant to the 0.01 level. Two of the nine identified concepts of plate tectonics were also found to have significant correlations.Similarly, a strong positive correlation was found between the proportion of chapters containing concepts of plate tectonics and the publication date. Thus, concepts of plate tectonics are found in more chapters in textbooks published during the latter parts of the study period.A concern arising from this study is the treatment of the concept identified as "The evidence for and the development of plate tectonics." This is the only identified concept of plate tectonics that showed a marked decrease during the study period. Furthermore, this concept corresponds with other studies that found many of America's textbooks reporting the end results of science while omitting the nature of science.Department of Geology
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Dahlin, Kretz Karin, and Signe Harlén. "Registered nurses’ experience caring for patients subscribed antibiotic treatment in The Philippines : An interview study." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-8705.
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Background: Antibiotic treatment of humans was introduced in 1930. The drug improved the living conditions globally due to the fact that bacterial diseases now could be treated. The development of antibiotic resistant bacteria is undeniable and globalization increases the spread of the resistant bacteria. The main reason for the emergence of resistant bacteria are incorrect and excessive use of antibiotics. Aim: The aim of the study is to investigate registered nurses’ experiences when caring for patients that have been subscribed antibiotic treatment. Method: A qualitative study with a semi-structured interview design based on interviews with eight nurses from one private hospital in The Philippines. The interviews were transcribed and analyzed using a qualitative content analysis. Result: Three themes were identified in the study, “To increase compliance”, “Nurses’ knowledge of antibiotic treatment” and “The nurses’ reflections on antibiotic treatment”. The first theme describes how the nurses provide a safe and open-minded environment for the patients, how to support and encourage the patient during treatment and how to give comprehensible information to the patient. The second theme describes the nurses’ knowledge of the emergence of antibiotic resistance, reasons for antibiotic treatment, the manifestation of antibiotic resistance and also the effects of antibiotic resistance. The third theme describes the nurses’ reflections and thoughts concerning antibiotics as well as how they perceive the population’s knowledge of antibiotics. Discussion: All of the nurses highlighted the poverty in The Philippines as the main reason for poor compliance. A large part of the population cannot afford to consult a doctor which results in people treating themselves without the proper knowledge. A majority of the nurses therefore request health education provided from the government. A private hospital also strives to please the patient which can result in doctors prescribing a lot of antibiotics to please their patients.
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Miller, Barbara Elaine. "Women under the influence: Stressors which increase alcohol consumption." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/887.
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Quintana, Frances. "Parent skills training for individuals in substance abuse treatment." CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/3066.
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This study examines the relationship between substance abuse and the need for parent skills training. Predicted is that adults in substance abuse treatment are likely to be in need of parent skills training. Previous research has associated the lack of parent skills with inept parenting practices that often leads to developmental problems in children.
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MacLennan, Karolyn Marie. "The Effect of Treatment Integrity on Student Achievement: A Quasi-Experimental Study." University of Dayton / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1279933719.
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Cheung, Chan-piu Bill, and 張燦彪. "An evaluation of the treatment of vocabulary in Hong Kong secondary school English textbooks." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B31649890.
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Cregg, James Giblin, and Joseph English. "A study to assess the post-treatment effectiveness of pedagogical instruction for union apprenticeship instructors." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/799.
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Barton, Michael Clinical School South Western Sydney Faculty of Medicine UNSW. "The improvement of cancer management by the application of the currently available knowledge." Awarded by:University of New South Wales, 2008. http://handle.unsw.edu.au/1959.4/39210.
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I have been intensively involved in the research on the application of currently available knowledge for the improvement of cancer care. This research covers the types of treatment that are appropriate for different clinical conditions (benchmarking and guidelines), planning services to improve access for patients, monitoring service delivery through patterns of care studies and development of the knowledge and skills of the cancer workforce. I devoted considerable effort to better educating the cancer workforce by measuring cancer teaching and developing model curricula and innovative teaching programs. I have made substantial contributions to knowledge about best practice by developing clinical practice guidelines and have developed tools and plans for cancer service delivery and have had a major influence on the training of the undergraduate and specialist medical workforce about cancer.
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Mntambo, Nomawabo. "A case study of oral linguistic error-treatment in second language classrooms where English is the medium of instruction." Thesis, Rhodes University, 1995. http://hdl.handle.net/10962/d1003320.
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One of the issues that have been debated at length in second language acquisition research circles is that of error-feedback and its desirability. Although there is as yet no conclusive evidence concerning its effectiveness in contributing towards the acquisition of a second language, a number of studies that have been conducted bear evidence to its desirability in L2 classrooms. This research then, was concerned with the way teachers of content subjects reacted to their learners' linguistically erroneous responses during oral interaction in their classes. The participants were four teachers who, with their pupils, are second language speakers of English . Three of these were content subject teachers while the fourth one teaches English. The data was collected from a class of Std 5 pupils in a rural school in the Eastern Cape where the lessons of these teachers were observed and audio-taped. Subsequently some of them were transcribed and analysed. The analysis of the data revealed that teachers in content subject classes, who teach through the medium of English showed more concern for content than for linguistic errors despite the fact that they are expected to extend the pupils' chances of second language acquisition.
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Conner, Dianna Holden. "Social skills training for individuals with schizophrenia: Evaluation of treatment outcome and acquisition of social and cognitive skills." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc4713/.
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Social and cognitive skill acquisition were evaluated in 33 (male=24, female=11) outpatients with schizophrenia or schizoaffective disorder. A social skills training treatment group (n=19) was compared to a wait-list control (n=14). Participants' mean age was 41 years, mean number of hospitalizations 10.4, and mean number of years with diagnosis 15.8. Assessment measures included WAIS-III Picture Arrangement subtest, Social Cue Recognition Test, COGLAB, WMS-III Word List subtest, and SADS-C. Results did not support the main hypotheses of improved social and cognitive skills in the treatment group. Participants with better memory and attention at pre-testing also did not show an advantage in social skills improvement. Contrary to hypotheses, the control group improved the most on some social and cognitive measures. Several supplemental hypotheses yielded the following results: lack of volunteer participation from paranoid schizophrenia individuals; evidence that schizoaffective disorder participants may be less cognitively impaired and better able to benefit from social skills training; and younger, less chronic participants with better attentional capacities may benefit most from social skills training. Findings are discussed in light of the possibility that improving social skills might not improve social and cognitive functioning, at least with the dosage of social skills training provided in this study. Limitations such as a sampling bias and small study size are also considered as possible explanations for the pattern of findings. Clinical and research implications are discussed to apply and extend the current findings.
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Adhyatman, Alexandra Anggraini. "Investigating the aptitude treatment interaction: Age, gender, computer self-efficacy and computer training." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/998.
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Farber, Kathleen Hickam. "An Experimental Study of Scotopic Sensitivity Irlen Syndrome in Learning Disabled Students." PDXScholar, 1994. https://pdxscholar.library.pdx.edu/open_access_etds/1329.
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This study examined the effect on reading performance of a controversial treatment for a dysfunction of visual perception known as Scotopic sensitivity/lrlen Syndrome. The treatment, referred to as spectral modification, involved the use of colored transparent overlays for reading by four elementary school children in their actual school environments. The diagnostic, prescriptive and remediation procedures used in this study were originally developed by Helen Irlen, a California psychologist and researcher. Irlen conceptualized Scotopic Sensitivity Syndrome as a difficulty in visual processing of the printed page when perceived through full spectrum light. Spectral modification techniques were considered controversial in that they were employed prior to scientific validation of the syndrome. Previous research used pre-test/post-test experimental designs to test the effect of spectral modification on reading performance. The research problem addressed here was that the technique had not been systematically examined over time in the school setting, and from the practitioner's point of view. Sample selection involved pre-screening and screening phases. The pre-screening procedures of teacher recommendation and file review resulted in a pool of 26 children who were screened with the Irlen Differential Perceptual Interview Survey. Four subjects were selected who were in separate school settings, who demonstrated Irlen Syndrome to a significant extent, and whose profiles did not present variables which would compromise their participation. These four underwent comprehensive vision evaluations as a preliminary assessment procedure. A four-strand single-subject experimental design was used to generate data on subjects' rate and accuracy of oral reading, and comprehension of silent reading. Performance changes during experimental reading trials varied between the four, although three subjects exhibited positive performance change on one indicator. A supporting procedure was that subjects were pre and post-tested on the three performance indicators. Post-test results corroborated the changes demonstrated by three subjects Interview formats were employed to obtain qualitative data from teachers, parents, and the subjects themselves. Recommendations for practitioners intending to implement spectral modification techniques were generated from this data.
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Or, Chun-wah, and 柯振華. "An investigation of the presentation and treatment of vocabulary in two secondary English textbooks in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45176425.
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Hardy, Rebecca B. (Rebecca Biggerstaff). "The Effectiveness of Say It Straight Communications Training With Adults in Outpatient Chemical Dependency Treatment." Thesis, University of North Texas, 1999. https://digital.library.unt.edu/ark:/67531/metadc935739/.
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The study compared an experimental group (n=26) who participated in weekly SIS sessions as an adjunct to existing treatment protocols for a period of 6-8 weeks, to a control group (n=14) who matriculated in treatment without the addition of SIS training for a period of 6-8 weeks. Subjects completed a battery of questionnaires at the beginning of the measurement period and at the end of the measurement period. The SASSI-2, The McMaster Family Assessment Device (FAD), and the Rotter Internal-External Locus of Control Scale were used to measure groups on recovery related variables at Pre-Test and Post-Test. Results demonstrated a consistent pattern of improvement over the time measure. The results of the interaction of group and time demonstrated a pattern of gains which did not reach statistical significance, partially as an artifact of the small sample size. An investigation of effect sizes was conducted to detect the effect of SIS training. The training was found to have a moderate effect size, which was consistent with other research using SIS training. Some areas for possible future research were addressed.
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Yang, Wei-Yun. "Doris Lessing's use of Sufi teaching stories : a study of the literary treatment of the theme of transformation in some recent novels by Doris Lessing." Thesis, Royal Holloway, University of London, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309742.
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Landis, Geraldine. "Heroes and villains : an analysis of the treatment of individuals in the world history textbooks /." Diss., This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-06062008-172039/.
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Doup, Mallory N. "THE ROLES OF SPEECH-LANGUAGE PATHOLOGISTS AND PSYCHOLOGISTS IN THE TREATMENT OF SELECTIVE MUTISM: A COMPARATIVE STUDY." Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1270840715.
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Green, Kerrie L. "A descriptive analysis of cardiac rehabilitation education programs." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1177976.
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The purpose of this research was to obtain information on the content of education within cardiac rehabilitation programs, methods of administering education, what the barriers are to providing education and which professionals administer education.To reach this goal, a questionnaire was modified from a previous study and a pilot study was undertaken to establish reliability of the questionnaire. The questionnaire was then sent to a sample of 100 directors of cardiac rehabilitation programs belonging to The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). The questionnaire focused on 13 established areas of education within cardiac rehabilitation programs.Once the questionnaires were completed, the information was transferred to a table format based upon the 13 content areas. The following conclusions were drawn from the research and the data gathered: 11 of the 13 content areas are offered at least 84% of the time, the major barriers for the 13 content areas were lack of time and lack of interest on the patient's behalf, the most frequent methods of education for all 13 content areas were individual education, print materials, and group education, and the primary educator overall for all 13 content areas was the nurse followed by the exercise physiologist and dietitian/nutritionist.Department of Physiology and Health Science
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Tsang, Hector W. H., and 曾永康. "The development of an indigenous treatment model of work-related social skills and work-related social skills training for people withschizophrenia in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31235360.
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Eva, Gail E. "Spinal cord compression secondary to cancer : disability and rehabilitation." Thesis, University of Stirling, 2007. http://hdl.handle.net/1893/245.
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Introduction This thesis describes a research study designed to examine the consequences of disability arising out of spinal cord compression secondary to cancer, and to examine the rehabilitation services available to patients. Research aims and questions The study was intended to achieve the following: 1. To ascertain what might constitute effective rehabilitation interventions for patients with metastatic spinal cord compression. 2. To identify the conditions in which these intervention might be delivered. 3. To ground proposals in spinal cord compression patients’ experience of disability. The following research questions were posed: 1. What are the consequences of disability for patients with metastatic spinal cord compression? 2. What strategies do patients themselves use to manage disability? 3. What do health care staff, particularly rehabilitation professionals, understand to be the consequences of disability for this patient group, and correspondingly, what are their views on the significance and provision of rehabilitation? 4. To what extent is rehabilitation being provided to these patients, and with what effect? 5. Where rehabilitation is not being provided, why is this the case? Study design The study had two components: • A series of nine in-depth interview-based case studies, which involved talking to patients about their experiences of living with spinal cord compression, as well as gaining the perspectives of family members and the health professionals who provided care and services. • A retrospective audit of the medical records of 73 spinal cord compression patients admitted to a radiotherapy in-patient unit (the Frank Ellis Unit at the Churchill Hospital in Oxford) over a two year period (July 2003 – June 2005), identifying disability-related problems and the measures taken to address them. This was a Phase I modelling study in terms of the Medical Research Council’s framework for evaluating complex interventions, with Pawson and Tilley’s (1997) Context-Mechanism-Outcome configuration adopted as a conceptual basis for data collection. Within-case analysis was informed by George and Bennett’s (2004) account of process tracing, and between-case analysis was modelled on the constant comparative method of Glaser and Strauss (1967) with an analysis of narrative as a variation on that theme. Results Disability is a serious problem for patients with spinal cord compression, but it is one problem among many others, not the least of which are the physical and emotional consequences of life-threatening illness. In response to disability, patients ‘twin-track’ their attitudes to it, acknowledging but also resisting the idea of themselves as disabled, and adopting a series of psychological devices to manage the tension. In effect, patients recognise that something significant has changed and that, as a consequence, new self-management skills must be learned, functional boundaries must be explored, useful information must be sought. At the same time, they display a determination to hold on to an established identity, associated with a sense of normality. This identity embraces the idea of competence and resourcefulness, the events, activities and pleasures that one looks forward to, and the wish to avoid burdening others. It is not a ‘disabled’ identity. To some extent, these two attitudes are in tension, as one acknowledges disability while the other, implicitly or explicitly, resists it. Consequently, patients try to find ways of resolving this tension, by ‘revising downwards’ their expectations, by constantly deferring the anticipated pleasures, and by avoiding situations in which their abilities might be put to the test, or the sense of normality be disconfirmed. Health care professionals are likely to construe the patient’s response as indicative of a certain type of character – ‘realistic’ on one hand, and ‘unrealistic’ on the other. They do not see ‘acknowledging / not acknowledging’ as twin facets of a complex response to circumstances, or as something which every patient engages in to one degree or another. Patients are motivated not to recognise rehabilitation as something they need, a view which is confirmed by the cursory form of rehabilitation experienced in hospital, and by the marginal significance attributed to it by nursing and medical staff. On discharge, hospital staff assume that rehabilitation needs will be identified in the community, although the way in which community rehabilitation services are organised virtually guarantees that this will not happen, unless a specific referral is made (as it is in only 5% of cases). The patient, meanwhile, remains unaware of the potential value of rehabilitation, and has no incentive to request rehabilitation if no-one offers it. They are consequently unprepared for life post-discharge, and assume that they (and their families) must manage on their own. Conclusions Like the patients, health care professionals may have to ‘twin-track’ if they are to provide rehabilitation in a way that is acceptable to patients with metastatic spinal cord compression. Instead of categorising patients as ‘realistic’ or ‘unrealistic’, they should work towards sustaining patients’ ‘positive illusions’, while at the same time taking whatever opportunities arise to enhance the patient’s day-to-day ability to function in a ‘safe’ space. This entails revising some deeply entrenched ideas about working with patients who have a disability: patient-centredness, the importance of goal setting, and the need for adjustment.
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Chen, Kaili. "Social Skills Intervention for Students with Emotional/Behavioral Disorders Aged Six through Twelve Years: A Combination of a Literature-Based Curriculum and Telecommunications." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc4466/.
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Researchers have noted that by providing formal and informal social skills training (SST), the school can become a potential optimal setting that fosters the development of social competence in students with behavioral problems. Indeed, learning to get along with people is one of the most important skills that we can teach students. In order to maximize its effectiveness, SST must be motivating and personally relevant enough for students to want to use the skills. In addition, it must provide opportunities for learned skills to be practiced under varying conditions and in as close to natural situations as possible in order to enhance the transfer of training. The purpose of the study was to investigate the social competence of students aged from six to twelve, diagnosed with emotional/behavioral disorders (E/BD) in a public self-contained school setting, and to increase the students' social competence by using a literature-based method that employs multiage grouping, impersonation, and telecommunications. By providing intensive, literature-based training in a multiage classroom, the SST gave students opportunities to practice skills in a natural, real-life environment and, therefore, increased the likelihood of generalizing these skills in other settings. The employment of impersonation and telecommunications also enhanced students' acquisition of social skills and their interests to learn.
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Cassidy, Aimee Kristine. "Resistance and perceptions of punitiveness as a function of voluntary and involuntary participation in domestic violence treatment programs." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1547.
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Hubbard, Robert Graham. "A case study, with specific reference to the role of parents, in the teaching and learning of a residential special school for children with autism." Thesis, Brunel University, 2015. http://bura.brunel.ac.uk/handle/2438/13727.
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Context: The purpose of this research was to examine if the educational approach (the Approach) adopted at Kilnbarn Residential Special School (the School) secured the developmental learning pathways for its pupils. All pupils were diagnosed with Autistic Spectrum Disorder (ASD), Severe Learning Difficulties (SLD) and many had single or multiple comorbid conditions. The research sought to understand how their parents could be substantive partners and co-creators in the design, modification, and implementation of the Approach. It was a unique feature of Kilnbarn’s Approach to fulfil the potential of parents to be co-creators and co-therapists in their child’s progress. Objective: The case study became one of the instruments in which to test the School’s effectiveness in meeting the needs of its pupils. It enabled a review of the School’s methodology, curriculum and organisational practices. The Approach was designed to provide secure developmental learning pathways for its pupils, improving their quality of life and independence. Method: The case study design, was chosen as it was considered the most appropriate research model. A Parents’ Questionnaire, distributed annually over 3 consecutive years (2004-6) was the evidential basis for this study. Interviews and collected data were used to analyse and evaluate the progress of the School through parents’ eyes. Results: The combination of parents working with professionals to maximise the culture of “technical eclecticism” seems to be, in the light of this case study, best suited to the needs of children diagnosed with autism, SLD and comorbid conditions. The child should be immersed in a consistent approach across all areas of their life. Improvements in well-being, communication and joint action routines, sleep balance, a healthy diet, physical exercise, incontinence and behaviours was observed. Conclusion The study identified that parents could be substantive partners and influencers in the design and modification of the Kilnbarn Approach. The Approach secured developmental learning pathways for its pupils and appeared to improve their quality of life. Parents as co-creators and co-therapists had regained ownership of their child’s quality of life, learning outcomes and personal development. From the experience and unique evidence of this case study schools should utilise and profit from the mass resource of their parents. It has been shown that the Kilnbarn Approach was, during the research, an effective and suitable intervention for the many children it served. It is hoped that further studies in this field will explore the concept of a “technical eclectic” approach that further validates and brings together interventions that are conceptually grounded and incorporates evidence-based focused intervention practices.
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Palmer, Sarah Morgando, and Tracy Lee Inman. "Perceived effects of a substance abuse prevention science program among fourth and fifth grade children: A qualitative study." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2418.
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This project explores the perceptions of fourth and fifth grade students who participated in a substance abuse prevention program. Risk and protective factors are presented to assist the reader in understanding this project.
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Goettl, Elizabeth J. "The emergence of joint attention in a naturalistic parent training program." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc6104/.
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Behaviors related to joint attention have been described by behavior analysts and developmental psychologists alike as having a distinctly social function. Children with autism often do not emit these behaviors. Research on the collateral effects of teaching joint attention suggests far reaching consequences. Given the reported benefits of using these behaviors, and the theoretical descriptions of their function, we assessed joint attention as a collateral effect of a naturalistic parent training program. Data suggest that although these behaviors were not directly targeted, they increased in all 3 children. Implications of parent training goals and child intervention targets are discussed in terms of a behavior analysis of joint attention and child development.
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Shetler, Michael Ray. "Waste minimization, household hazardous waste, and a model curriculum guide for regional occupational programs for the County of Riverside Department of Health Environmental Health Services." CSUSB ScholarWorks, 1990. https://scholarworks.lib.csusb.edu/etd-project/528.
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Ssebuliba, Doreen. "Mathematical modelling of the effectiveness of two training interventions on infectious diseases in Uganda." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85637.
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Thesis (PhD)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Nurses, midwives and clinical officers referred to as Mid-level Practioners (MLPs) play an important role in the health care system especially in rural Africa. With particular reference to rural Uganda, due to the large shortage of doctors, MLPs handle most of the duties usually meant for doctors, at health centre IV(s). From 2009 to 2011, two training interventions of MLPs were performed at 36 sites in Uganda by the Integrated Infectious Disease Capacity Building Evaluation (IDCAP). The two interventions were: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS) which aimed at improving MLPs’ case management for four diseases: HIV, TB, pneumonia and malaria. In this thesis, we have developed three mathematical models to investigate the effect of the two training interventions on these infectious diseases. All the models are formulated using systems of ordinary differential equations which are structured in three age groups: [0, 5), [5, 14) and [14, 50). We explored the effect of the two training interventions in the context of malaria-pneumonia, HIV-TB co-infections and the four diseases together. Our analysis shows that: i) For malaria-pneumonia, both IMID and the combination of IMID and OSS reduce the number of cases, deaths and prevalence of disease but have no effect on the incident episodes of disease. ii) Results from the HIVTB model propose that HIV and TB testing are important steps in quality of health care and are capable of offsetting slightly negative effects of reduction in ART enrollment and provision of treatment. iii) The HIV-TB-malaria-pneumonia (HTMP) model concurs with the results of the first two models and its results demonstrate that high coverage levels of the training interventions increase the positive effects that the interventions have on mortality and morbidity. Overall, our results suggest that training of MLPs is much more effective for the short term duration diseases such as malaria and pneumonia, where the baseline values for most of the performance indicators are ≥ 0.6, but not so much for long term duration diseases such as HIV and TB, whose baseline values for most of the performance indicators are < 0.6. The results further highlight that problems such as case detection and drug stock-outs need to be addressed in order for training to have substantial impact, especially in instances where the performance indicator proportions are low.
AFRIKAANSE OPSOMMING: Verpleegsters, vroedvroue en kliniese beamptes wat gesamentlik na verwys word as midvlak praktisyns (MVPs) , speel n belangrike rol in die gesondheidsorg sisteem, veral in landelike dele van Afrika. Met spesifieke verwysing na gesondheid sentrums in Uganda, waar daar te min dokters is, hanteer MVPs die meeste van die pligte wat eintlik deur dokters verrig moet word. Vanaf 2009 tot 2011 is twee opleidingsprogramme vir MVPs by 36 fasiliteite in Uganda deur die Integrated Infectious Disease Capacity Building Evaluation (IDCAP) organisasie aangebied. Die twee programme staan bekend as: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS). Beide die programme stel ten doel om die MVPs se pasint bestuur vir die siektes MIV, tuberkulose (TB), longontsteking en malaria te verbeter. Drie wiskundige modelle word in hierdie tesis ontwikkel om die effek van die opleidingsprogramme op hierdie oordraagbare siektes te ondersoek. Al die modelle word geformuleer deur gebruik te maak van stelsels van gewone differensiaal vergelykings wat gestruktureer is in drie ouderdomsgroepe: [0, 5), [5, 14) en [14, 50). Die effek van die opleidings programme word in die konteks van longontstekingmalaria mede-infeksie, MIV- TB mede-infeksie en al vier siektes gelyk, ondersoek. Die analise wys dat: i) Vir longontsteking-malaria mede-infeksie het beide IMID en die kombinasie van IMID en OSS die aantal siekte-gevalle, sterftes en die prevalensie van die siektes verminder, maar het geen effek op die insidensie van siekte-gevalle nie. ii) Resultate van die MIV-TB model dui aan dat MIV en TB toetsing n belangrike aspek van die gehalte van sorg is en dat dit die effense negatiewe effek van die afname in ART inskrywing en voorsiening van behandeling, teenstaan. iii) Die MIV-TB-longontsteking-malaria model (HTMP) stem ooreen met die resultate van die bogenoemde twee modelle en demonstreer dat ho dekking van die opleidingsprogramme die positiewe effek van die programme op mortaliteit en morbiditeit verhoog. In geheel stel die resultate van hierdie studie voor dat die opleiding van MVPs baie meer effektief is vir die korttermyn siektes soos malaria en longontsteking waarvoor die meeste van die beginwaardes van die prestasie-aanwysers ≥ 0.6 is, maar nie soveel vir lang-termyn siektes soos MIV en TB waarvoor die meeste van die beginwaarde van die prestasie-aanwysers < 0.6 is. Die resultate dui verder aan dat opleiding nie voldoende is wanneer die prestasie-aanwysers < 0.6 is nie en dat probleme soos die opsporing van siekte-gevalle en n gebrek aan medisyne by die klinieke aangespreek moet word vir opleiding om aansienlike impak te hê.
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Siracuse, Kimberly S. "Engendered & Endangered: A Phenomenological Study of the Lives of Twelve Female Social Studies Teachers." Ashland University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ashland1319659422.
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Mphana, Mateboho Patricia. "HIV/AIDS prevention and care for learners in a higher education institution in Lesotho." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5307.
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Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: HIV/AIDS is considered as a global problem with the number of people living with HIV infection continuing to increase. At the end of 2007 HIV/AIDS had already claimed 25 million lives. Of all new HIV infections 71% were diagnosed in the Sub-Saharan region in 2008, remaining the worst affected region globally. UNAIDS (2008:43) indicated that heterosexual intercourse remained the main origin for HIV infection in the Sub-Saharan region. Therefore the researcher is of the opinion that prevention strategies should focus mainly on sexual transmission of the disease. HIV/AIDS affects mainly people between the ages 15-24 years, notably the age group of most of the learners in Higher Education Institutions (HEIs). Lesotho, a country in the Sub- Saharan region, presents with the third highest HIV adult prevalence (23.2%) in the world and in the region. In an attempt to address the prevailing situation, Lesotho has a number of programmes geared towards addressing HIV/AIDS in the country. However, all these attempts exclude the learners in HEIs, yet the majority of learners are found within the most affected age group. It is also to be noted that Higher Education provides the bedrock for socio-economic and political development in Africa. Some studies have identified insufficient knowledge as being at the root of the increasing HIV infections among youth. However, other studies have shown that there is adequate knowledge among the young people, but still a challenge remains and that is to facilitate changes in behavioural patterns as a component to be linked to the knowledge. Studies conducted in other African countries have shown that there are anti-AIDS programmes and clubs for learners in HEIs where learners are involved in the fight against HIV/AIDS. No publication indicating the same for Lesotho’s HEIs could be found, except for the National University of Lesotho (NUL) that only launched its HIV/AIDS policy for learners in 2009. The researcher is of the opinion that HEIs in Lesotho are not doing enough to combat HIV/AIDS and hence intends to focus on HEIs in Lesotho. This study had two objectives namely: To determine the knowledge of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. To explore the needs of learners in a specific HEI in Lesotho regarding HIV/AIDS prevention and care. This mixed method study was conducted, comprising of both quantitative and qualitative designs. Quantitative phase used a questionnaire for determining the knowledge of learners. The questionnaire was adopted from a study that was performed to determine knowledge of South African educators in public schools with some modifications. The qualitative phase was used to explore the needs of the learners through the focus group discussions with the leaders of the learners. Sample was drawn from the entire population using stratified random sampling for the quantitative phase. The qualitative phase used the purposive sampling to obtain in-depth information concerning learners’ needs. Quantitative data was analysed through the use of statistical package for social sciences (SPSS) and qualitative data was analysed using the thematic analysis and open-coding. All ethical principles were adhered to especially the principle of respect for persons. The findings from the quantitative phase of the study showed that learners had adequate knowledge regarding HIV/AIDS prevention and care and the findings from the qualitative phase showed the various needs of the learners with regards to prevention and care of HIV/AIDS in a specific HEI in Lesotho. Recommendations have been proposed based on the findings from the two phases of the study. Limitations observed by the researcher have also been identified. In conclusion the objectives of the study were met and the research questions had been answered.
AFRIKAANSE OPSOMMING: MIV/Vigs word as ‘n internasionale probleem erken, siende dat daar ‘n verhoging in die toename van MIVgeïnfekteerde indiwidue tans is . Einde 2007 het MIV/Vigs het reeds 25 miljoen lewens ge-eis . In 2008 is 71% van al die nuwe MIV-infeksies in die Sub-Sahara streek gediagnoseer, wat aandui dat die streek die mees geaffekteerde streek tans is. UNAIDS (2008:43) het aangedui dat heteroseksuele omgang die hoofoorsaak van MIV-oordrag in die Sub-Sahara-streek is. Laasgenoemde het daartoe gelei dat die navorser van mening is dat voorkomende strategieë meestal op seksuele oordrag van die siekte moet fokus. MIV/Vigs affekteer meestal mense in die ouderdomsgroep 15-24, opmerklik is dit die ouderdomsgroep waarby meesste leerders in Hoëronderwysinstellings (HOI) is. Lesotho, ‘n land in die Sub-Sahara-streek, het tans die derde-hoogste MIV-voorkoms (23.2%) in die wêreld en in die streek. Lesotho het verskeie programme ontlont om MIV/Vigs te bekamp in ‘n poging om die huidige situasie te beredder . Nieteenstaande sluit al die programme leerders in HOI uit, alhoewel die leerders in die ouderdomsgroep van die mees-geaffekteerde groep val. Dit is ook duidelik dat Hoëronderwys die fondasie vir sosio-ekonomiese- en politieke ontwikkeling in Afrika verskaf. Sommige studies het onvoldoende kennis as die wortel van die verhoging van MIV-infeksies onder die jeug geïdentifiseer. Ander studies, daarenteen, wys dat kennis voldoende is onder jeug, alhoewel veranderinge in gedragspatrone om by die kennis aan te sluit ‘n uitdaging bly. Studies uit ander Afrikalande dui daarop dat daar anti-Vigs programme en klubs is waarby HO leerders betrokke is om teen die verspreiding van MIV/Vigs te veg. Geen publikasies in hierdie verband word in Lesotho aangetref nie, behalwe ‘n MIV/Vigs-beleid wat in 2009 deur “National University of Lesotho’ (NUL) gepubliseer is. Dus is die navorser van mening dat HOI nie genoeg doen om MIV/Vigs te beveg nie, daarom fokus sy op HOI in Lesotho. Hierdie studie het twee doelstellings ten doel gehad, naamlik om die leerders in ‘n sekere HOI in Lesotho se kennis aangaande MIV/Vigs voorkoming en sorg te bepaal en die behoeftes van die leerders aangaande MIV/Vigs voorkoming en sorg te verken. ‘n Studie met beide kwantitatiewe- en kwalitatiewe metodes is gebruik om die doelstellings te verwesenlik. In die kwantitatiewe fase is ‘n vraelys gebruik om leerders se kennis te bepaal. Die vraelys is verkry uit ‘n vorige studie wat in RSA gedoen is, maar aangepas om in die Lesotho-konteks te gebruik. Gedurende die kwalitatiewe fase is fokusgroep besprekings met die leiers van die leerders gehou om die behoeftes indiepte te verken. Die steekproef was uit die totale populasie getrek deur van gestratifiseerde streekproefneming gebruik te maak in die kwantitatiewe fase en ‘n doelgerigte steekproefneming is in die kwalitatiewe fase te gebruik. Die navorser het ‘n kwantitatiewe data-analise sagteware (SPSS)gebruik om kwantitatiewe data te ontleed en tematiese- oopkodering is gedurende die kwalitatiewe fase gebruik. Etiese kode is ten volle gerespekteer, veral die respek vir mense gedurende navorsing. Bevindinge van die kwantitatiewe fase het bewys dat leerders voldoende kennis aangaande die voorkoming en sorg van MIV/Vigs besit en die kwalitatiewe bevindinge het die behoeftes van leerders met betrekking tot die voorkoming en sorg van MIV/Vigs in ‘n spesifieke HOI in Lesotho geopenbaar. Die aanbevelings is gemaak, gebaseer op die bevindinge uit die twee fases. Beperkinge in die studie is uitgelig. Ter afsluiting is die doelstellings in die studie bereik en die navorsingsvrae beantwoord.
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Boaventura, Ana Paula. "Avaliação do processo ensino aprendizagem das manobras de ressuscitação cardiorrespiratória (RCP) utilizando o desfibrilador externo automático (DEA): alunos de graduação da área da saúde." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-31052011-110626/.
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Os profissionais da área de saúde deparam-se constantemente com situações que envolvem risco de vida para os clientes, uma delas é a parada cardiorrespiratória (PCR) e necessita que sejam instituídas mais rapidamente as manobras de ressuscitação cardiopulmonar (RCP) que compreende o Suporte Básico de Vida (SBV) e o uso de Desfibrilador Externo Automático (DEA). Trata-se de um estudo exploratório descritivo com o objetivo de identificar a HABILIDADE (prática) e o CONHECIMENTO (teórico) dos alunos dos cursos de graduação da área da saúde, de uma universidade privada no interior do Estado de São Paulo, antes e após serem submetidos ao curso/ treinamento. A coleta dos dados foi dividida em duas etapas sendo: 1ª. Etapa - avaliação do conhecimento teórico e prático prévio antes de um curso teórico com demonstração prática das manobras de RCP com uso do DEA e treinamento utilizando o laboratório de práticas com o manequim de RCP e o DEA; 2ª. Etapa avaliação teórica e prática individual. Foram incluídos 173 alunos com faixa etária de 17 a 23 anos, 151 (87,3%) do sexo feminino; na Avaliação da HABILIDADE na 1ª. Etapa, a pontuação máxima foi de 91 pontos 69 (39,9%) alunos e 104 (60,1%) alunos não pontuaram, na 2ª. Etapa a pontuação máxima obtida foi de 260 pontos por 101(58,4%) alunos. Na Avaliação do CONHECIMENTO, a pontuação máxima foi de 5,75 pontos e a pontuação mínima de 1,0 ponto na 1ª. Etapa. Na 2ª. Etapa, a pontuação máxima foi de 10,0 pontos por sete (4,0%) alunos, nenhum aluno obteve pontuação inferior a 7,5 pontos. Para 19 itens a diferença foi significativa na Avaliação da HABILIDADE da 1ª para a 2ª. Etapa em todos os grupos de conteúdos sendo: Avaliação inicial e responsividade 2 itens; Abertura das vias aéreas e manobras de respiração - 6 itens; Avaliação do pulso carotídeo e compressões torácicas - 3 itens e Manuseio do DEA 8 itens. Para 9 questões a diferença foi significativa na Avaliação do CONHECIMENTO da 1ª para a 2ª. Etapa em dois grupos de conteúdos: Abertura das vias aéreas e manobras de respiração - 3 questões e Manuseio do DEA 6 questões. As 13 questões que não apresentaram bom desempenho na 2ª. Etapa do estudo, no Conhecimento, estão agrupadas nos conteúdos: Avaliação inicial e responsividade; Abertura das vias aéreas e manobras de respiração e Manuseio do DEA. Quanto comparados a HABILIDADE e o CONHECIMENTO verifica-se que houve melhora no desempenho da primeira para a segunda etapa em todos os itens e questões (p=0,0001). Quanto ao treinamento a média do tempo de observação foi de 78,3 minutos e o tempo de treino foi de 117,1 minutos. Em relação à HABILIDADE os itens que não atingiram bom desempenho na 2ª. Etapa estão nos conteúdos Avaliação inicial e responsividade e Manuseio do DEA e em relação ao CONHECIMENTO as questões que não atingiram bom desempenho estão nos conteúdos Avaliação inicial e responsividade; Abertura das vias aéreas e manobras de respiração e Manuseio do DEA. Conclui-se que tanto na HABILIDADE quanto no CONHECIMENTO houve melhora no desempenho dos alunos.The health professionals faced with situations involving risk of life for patients, one of them is cardiopulmonary arrest (CA) and needs to be established more quickly cardiopulmonary resuscitation (CPR) involving the Basic Life Support (BLS) and use of Automated External Defibrillator (AED) This is a exploratory study aiming to identify the skill (practice) and knowledge (theoretical) of the students in health undergraduate students in a private university in the state of São Paulo, before and after their submitted to the course / training. Data collection was divided into two stages as follows: 1st. Step - Evaluation of knowledge practical and theoretical and course with prior practical demonstration of CPR maneuvers using the AED, 2nd. Step - training and theory/practice evaluation individual, using laboratory practices with the manikin CPR and AED. 173 students were included aged 17 to 23 years, 151 (87.3%) were female; the skill evaluation in the 1st. Step, the maximum score of 91 points was 69 (39.9%) and 104 students (60.1%) were not scored in the 2nd. Step a maximum score of 260 points was obtained for 101 (58.4%) students. The Knowledge evaluation, the maximum score was 5.75 points in the 1st. Stage and a minimum score of 1.0 in the 2nd. Step, the maximum score was 10.0 points in seven (4.0%) students, no students scored less than 7.5 points. For 19 items the difference was significant in the skill evaluation the 1st to 2nd. Step in all groups of content being: \"Initial evaluation and responsiveness\" - 2 items, \"Opening the airway and breathing maneuvers\" - 6 items, \"Evaluation of the carotid pulse and chest compressions - items 3 and \" Handling the DEA \"- 8 items. In nine questions for the difference was significant in the Knowledge evaluation from the 1st to 2nd. Step into two groups of content: \"Opening the airway and breathing maneuvers\" - three questions and \"Handling the DEA\" - 6 issues. The 13 questions that did not show good performance in the 2nd. Stage of the study on Knowledge, are grouped by content: \"Initial evaluation and responsiveness,\" \"Opening the airway and breathing maneuvers\" and \"Handling the DEA.\" As compared with the skill and knowledge there is a significant improvement in performance from first to second step on all the items and issues (p = 0.0001). As for training the average observation time was 78.3 minutes and the workout time was 117.1 minutes. Regarding skill items that did not achieve good performance in the 2nd. Step in the contents are Initial evaluation and responsiveness and Handling the DEA and about the knowledge the questions that are not achieved a good performance in the contents Initial evaluation and responsiveness, Opening the airway and breathing maneuvers and Handling the DEA. We conclude that both the skill and knowledge in significant improvement in student performance.
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Barford, Kirsty-Lee. "Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1015678.
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South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
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Ramela, Thato. "An illustrated information leaflet for low-literate HIV/AIDS patients on antiretroviral therapy : design, development and evaluation." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1007563.
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South Africa's HIV prevalence rate is estimated to be 5.7 million and at the end of2007 a total of 45845 HIV/AIDS adult patients were taking antiretroviral therapy (ART). The global incidence of HIV/AIDS has been slowly decreasing over the years but is still widespread. This disease is still more prevalent in sub-Saharan Africa than in other parts of the world, with more than 60% people living with HIV/AIDS. Highly active antiretroviral therapy (HAART), the treatment of choice, slows the progression of the human immunovirus but demands a high adherence rate in excess of 95%. Patients who are poorly informed about antiretrovirals (ARVs) and misunderstand medicine-taking instructions or experience unexpected side effects may interrupt therapy, predisposing them to the development of resistance. Such patients need information but, given the poor literacy skills prevalent in South Africa, written information is often not fully comprehended and is often written at too high a reading level. The objectives of this research project were to design, modify and evaluate HIV / AIDS patient education materials for low-literate isiXhosa speaking adults residing in Grahamstown and to examine their impact on the understanding of various aspects of the disease and its treatment. Pictograms illustrating common side effects of ARVs (e.g. stavudine, efavirenz, lamivudine), as well as various sources 'for purchasing nonprescription medicines, storage and medicine-taking instructions were designed and evaluated both qualitatively, using group discussions, and quantitatively through individual interviews where interpretation of the pictograms was assessed. These pictograms were incorporated in a patient information leaflet (PIL) which had been specifically designed for people with limited reading skills and was a simple document containing the minimum of essential text. A previously developed PIL was modified in collaboration with the target population and two versions were produced, one incorporating pictograms illustrating side effects, the other with none. Pictograms were used in both to illustrate other medicine-taking instructions. The PILs were tested objectively to assess the readability, format, content, and general design. They were translated into isiXhosa prior to being qualitatively and quantitatively evaluated in a low-literate isiXhosa speaking population. Understanding of the PILs was assessed by asking a series of questions about the PIL content. Participant opinion of the readability and appearance of the PIL was recorded. The relationship between PIL understanding and selected demographic variables was investigated. Findings from this study illustrated that well designed pictograms assist in the location of information in written leaflets and they may enhance understanding of the information. It was further demonstrated that education influences total understanding of PIL content thus emphasizing the need for tailor-written information in accordance with the education level of the target population. A desire to receive PILs incorporating pictograms was expressed by the majority of participants. Collaboration with the intended target population is essential to design culturally acceptable, easily interpreted pictograms and to produce user-friendly, easy-to-read, comprehensible patient education materials. The rigorous, iterative design, modification and testing process described in this study is one that should be adopted in producing all health-related education materials.
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Mwingira, Betty. "Development and assessment of medicines information for antiretroviral therapy in Sub-Saharan Africa." Thesis, Rhodes University, 2005. http://hdl.handle.net/10962/d1003257.
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Campbell, Laura. "Certain the curriculum ; uncertain the practice : palliative care in context." Thesis, 2012. http://hdl.handle.net/10413/6235.
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This study opens in a critical paradigm and explores the previously unheard experiences of caregivers who have been trained in and who practice palliative care in a context of rural African, isolated, profoundly impoverished homes. Instead of a healthcare focus, the study used curriculum theory to provide a fresh look at and to better understand palliative care in context. Curriculum theory distinguishes a curriculum as preactive (espoused) or interactive (enacted), and preactive and interactive curricula for palliative care were compared and interrogated as exemplarity of a circumstance when a curriculum is transported into a context other than that where it originated.
The study offers several contributions to health sciences, including a link between curriculum theory and palliative care, and provides deep insights into the experiences of those who practice palliative care with limited guidance and support from senior healthcare professionals.
In the 1970s palliative care developed in a hospital context in the United Kingdom as a response to ideas which included that society is death-denying and that medicine and associated sophisticated technology act to render patients passive spectators in care decisions. An aim is to coordinate and plan care which includes a focus on empowering patients and their families by giving them choices around living with a life-shortening illness and dying as comfortably and peacefully as possible. A common theme is an intention to relieve or prevent suffering, and palliative care services have developed throughout the world. Palliative care is delivered by healthcare professionals acting within a multidisciplinary team who provide care at various sites including hospitals, homes and hospices.
Palliative care has been introduced to post-apartheid South Africa relatively recently, and the preactive palliative care curriculum is largely based on notions of palliative care which developed in a European context while the interactive curriculum is enacted in rural African homes.
Ideas around palliative care may not have a universal or rigid quality, but may represent an agreement among people in a certain context and the unexplored introduction of such ideas into another context may potentially give rise to a hegemonic flow of ideas. Systemic challenges around healthcare in Africa may preclude a patient from having choices in their healthcare. The agency of patients may be undermined by their material living conditions.
The study site was rural KwaZulu-Natal in South Africa, where the incidence and prevalence of Human Immunodeficiency Virus are the highest in the world. Study questions revolved around a curriculum as a source of knowledge for practice and experiences of a context and practice. Data sources were twofold: firstly a palliative care curriculum text was scrutinized and analyzed in terms of who is cared for, place of care, work of caregivers and palliative care; and secondly data from participants (nurses and home-based care workers) were analyzed to produce deep insights into their experiences of practising in context. Data were generated using a visual technique of “photo-elicitation”, where participants were invited to discuss photographs they took to convey their experiences, and analyzed inductively using naturally emerging themes.
Curriculum data indicated that patients should be offered palliative care when there is awareness that they face a life-limiting illness, and a focus was on home care. The espoused curriculum foregrounded physical care and placed less emphasis on aspects such as spiritual, cultural or psychosocial care; the curriculum was delivered at a site distant to caregivers’ practice. In South Africa the legacy of apartheid lingers, and data from caregivers revealed that physical conditions are harsh in that patients are starving, housed in makeshift shelters and face profound social challenges. Spiritual care and cultural care were highly valued, as patients map onto traditional beliefs and cultural practices
Data revealed that caregivers were sometimes unsure, angry, felt powerless and could be placed in physical and emotional danger. Patients and their families valued some aspects of palliative care, such as preparing for death and bereavement support, but found challenges in understanding other aspects such as why caregivers did not appear to make attempts to cure disease.
Juxtaposing study findings with published literature revealed that diametric worldviews of teachers and learners have an impact on curriculum delivery. The home could be a beneficial place for care but could also create challenges.
The study theorizes beyond a palliative care curriculum, and in concluding the study I found that I must move from a critical to a post-structural paradigm. A critical paradigm seeks data around oppression and marginalization so that transformation may be enacted, and data indicated that aspects of the practice of palliative care were both empowering and disempowering for caregivers; they were empowered by being able to practice in an independent, autonomous way, but were also disempowered since the curriculum did not adequately consider context.
The study unearthed no universal truth for a curriculum for palliative care; an African curriculum should take cognizance of an African context. I use the study findings to put forward a thesis around certainty in curriculum, and the study prompts understanding of certain curriculum in contexts that are uncertain.
Key words: Certainty, curriculum, palliative care practice, context, rural homesThesis (Ph.D.)-University of KwaZulu-Natal, Edgewood, 2012.
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Nunes, Artur Pedro Lapa. "An insight study of the state of the palliative treatment in Portugal." Master's thesis, 2013. http://hdl.handle.net/10071/6677.
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After cardiac diseases, oncological conditions1 represent one of the most important causes of death and pain in OECD countries in one hand, and on the other an important financial burden in National Health Systems (NHS). To improve patients’ lifetime the traditional approach has focused mostly at the clinical and treatment levels. However, a number of emerging studies have brought to the forefront of the discussion the increasing importance of Palliative Care treatments. In the USA alone, more than 70% cost savings have been achieved in studies focusing on improving the quality of life of the patient and on cost avoidance techniques (R. Sean Morrison, et al., 2008). In spite of this, there is little evidence of the existence of such studies in Portugal. Accordingly, it would seem highly valuable for the NHS to take notice of what is the state of art in best in class countries and possibly adopt a number of recommendations and best practices with proven results elsewhere. The specific goals of this thesis are then to be: 1. To develop a case study in order to understand if the best in class Palliative Care techniques are being used in Portugal; 2. To understand what the potential savings could be, in an extremely pronounced downturn of the Portuguese economy, without compromising the quality of the service provided by our NHS.
In an inquiry conducted to 42 health professionals in Portugal, we have validated a number of improvement opportunities in the current Palliative Care practice which, if applied could have considerable economic and social benefits.Depois das doenças cardíacas as doenças oncológicas representam uma das maiores causas de morte e dor nos países da OCDE, sendo também um dos maiores encargos nos sistemas nacionais de saúde (SNS). Para melhorar a qualidade de vida dos pacientes a medicina em temos tradicionais tem-se focado, principalmente, a nível clínico e nos seus tratamentos. No entanto um número de estudos emergentes veio trazer para discussão o aumento da importância dos cuidados paliativos. Nos Estados Unidos da América foram obtidos mais de 70% de redução de custos em estudos que visaram o aumento da qualidade de vida dos pacientes e técnicas de diminuição de custos (R. Sean Morrison, et al., 2008). Ainda assim há pouca evidência da existência deste tipo de estudos em Portugal. Em consonância com o já referido seria então bastante valioso para o SNS verificar qual o estado de arte nos países mais desenvolvidos para adotar possíveis recomendações e melhores práticas com resultados comprovados neste domínio. Os objetivos específicos desta tese são então: 1. Desenvolver um estudo de caso para perceber quais são as melhores práticas em cuidados paliativos a serem usados em Portugal 2. Perceber quais são as potenciais poupanças, numa altura de recessão da economia portuguesa, sem comprometer a qualidade de serviço prestado pelo SNS Num inquérito elaborado a 42 profissionais da saúde em Portugal, validamos um conjunto de oportunidades de melhoria na atual prática de cuidados paliativos, que se aplicados irão trazer consideráveis benefícios económicos e sociais.
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Spichiger, Elisabeth. "Leading a life with a terminal illness : an interpretive phenomenological study of patients' and family menbers' experiences of hospital end-of-life care /." 2004. 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:3136071.
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Foster, Terrah Leigh. "A mixed method study of continuing bonds maintaining connections after the death of a child /." Diss., 2008. http://etd.library.vanderbilt.edu/ETD-db/available/etd-03302008-221648/.
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Moodley, Aneetha Devi. "A study into palliative care services for offenders with AIDS at Westville Prison." Thesis, 2006. http://hdl.handle.net/10413/2221.
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The study sought to determine what palliative care services were provided to offenders at Medium B correctional center, which is located at Durban Management Area. It identified the perceptions of offender-patients about the services they received. The study also identified challenges that staff and offender-volunteer caregivers faced in rendering services within a correctional context in South Africa. The sample consisted of three stakeholders, namely, offender-patients who were terminally ill with AIDS at the prison hospital, staff and offender volunteer caregivers. The methods of data collection comprised of content analysis, semi-structured interviews with offender-patients and focus group discussions with staff and offender volunteer caregivers. The study revealed that efforts were made by the Department of Correctional Services to provide services to terminally ill AIDS patients. Legislation and policy frameworks were consistently being developed by the Department to meet the needs of patients and to keep abreast with international best practices. Some services were in accordance with the theoretical framework of palliative care. However, many challenges were experienced because of the contextual constraints in which the services were being rendered. Recommendations to improve the delivery of services were made by all participants in the study. The study concludes with the recommendations by the researcher and suggestions for future research.Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2006.
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"Teaching Doctors to Respond with Empathy: A Pilot Study." Master's thesis, 2020. http://hdl.handle.net/2286/R.I.57404.
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abstract: Empathy is a critical component of high-quality healthcare. When present in the clinical encounter, empathy is important to physicians (empathy is correlated with reductions in physician anxiety and burnout) and to patients (empathy is correlated with better medical decision making, enhanced trust, and improved treatment adherence). Unfortunately, there is an empathy gap in healthcare–physicians often miss opportunities to demonstrate empathy to their patients. This leaves patients feeling unheard, less likely to bring up details important to their care, and less likely to follow treatment guidelines from physicians, thus disrupting the physician-patient relationship. Luckily, communicating with empathy is a skill that can be taught and learned. With the right tools, learners can strengthen their empathic muscle and become better prepared for responding in difficult situations. The present thesis aims to validate a new tool for teaching empathy to medical trainees. This tool, an empathic communication guide, is drawn from social work as well as medical expertise. It is catered specifically to how medical trainees are accustomed to learning and provides the actual words to say in order to respond with empathy in difficult situations. A group of 8 palliative care fellows at MD Anderson Cancer Center in Houston, Texas received a copy of this guide and participated in an accompanying communication workshop. To gauge empathic responding ability, fellows completed pre- and post- surveys and patient simulations. These data were analyzed using a combination of novel and established methods for quantifying empathic behaviors. Fellows’ empathic communication skill significantly improved after exposure to the guide opening avenues for future study and application.Dissertation/Thesis
Masters Thesis Social Work 2020