Дисертації з теми "Behaviour change outcomes"
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1
Cheng, Wen-Hung (Ryan). ""Change for the better: The impact of Team Wise Proactive Change Management on burnout and team outcomes"." Thesis, Discipline of Work and Organisational Studies, 2023. https://hdl.handle.net/2123/29950.
Анотація:
Past research on proactivity has focused on the frequency of proactive behaviours of individuals rather than the content of such behaviours and its operationalisation within teams. It is no longer sufficient to be merely proactive when dealing with ongoing changes within organisations or working when working in teams. My thesis introduces team wise proactive change management (TWPCM), where teams proactively manage change in ways that consider the situational, relational, and their own resources in addressing future challenges and reaching their goals. This paper examines the impact of TWPCM on burnout and the flow-on effects to team withdrawal and performance outcomes within the healthcare sector. To examine this, I propose three research questions: Does TWPCM alleviate burnout within healthcare teams?, Does the effect of TWPCM on burnout flow onto withdrawal and performance outcomes within the teams?, and Do work demands inhibit the positive benefits of TWPCM and its effects on burnout, withdrawal and performance outcomes within healthcare teams?. I employed a quantitative research design and drew on team aggregated survey data from a local health district in NSW, comprising 2324 nurses and midwives across 196 teams,. I also linked this survey data in terms of participants’ perception work to objective archival data across 12 months post survey completion, including patient safety data – specifically the number of medication and IV-related errors, as well as human resources data on leave and turnover. Findings show that TWPCM was indirectly negatively associated with undesirable team outcomes (team turnover, absenteeism and medication and IV errors) via burnout. Further, work demands moderated these indirect effects, whereby the relationship was weaker (creating barriers to alleviating undesirable consequences) when work demands are high. Importantly, the results indicate that wise proactive behaviours have theoretical and practical implications on healthcare workers and hospitals, and future researchers. My findings shed light on to the
important role of wise proactive change management for teams and advances the empirical evidence and knowledge on how to effectively manage change to benefit not just organisations but also employees and the society.
2
Payne, Janette Elizabeth. "Relationship between psychosocial characteristics of clients and outcomes of dietary intervention methods." Thesis, Queensland University of Technology, 2000. https://eprints.qut.edu.au/36767/1/36767_Payne_2000.pdf.
Анотація:
This study contributed to best practice dietary management of clients with heart disease in a number of ways. It compared the effectiveness of five different styles of delivery of dietary intervention in clients with heart disease. It considered the associations between pyschosocial and other individual characteristics and dietary intervention outcomes and reviewed the usefulness of many currently recommended outcome measures. Resources and recommendations were also developed to allow the incorporation of the findings into clinical practice.
277 male clients with demonstrated coronary heart disease were recruited from The Prince Charles Hospital during 1998. Participants were allocated to five groups: individual counselling, single group session, multi-group sessions, handout only or study questionnaires only. Dietary intervention was provided to the first four groups. Demographic, anthropometric, biochemical, dietary and psychosocial data were collected from participants at baseline, 3 months and 6 months post intervention. A specially designed education resource 'Key to Healthy Heart Eating' was developed and used in the dietary intervention groups.
All interventions resulted in improvements or positive outcomes for some of the variables measured, with many achieving statistical significance as noted in the results section. Positive changes to clinical (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), anthropometric (body mass index, waist hip ratio), behavioural and psychosocial outcome measures occurred for many individuals over the 6 month study period. The 'questionnaires only' intervention was shown to be significantly less effective for promoting improvement in anthropometric outcome measures compared to the dietary interventions considered. However, between these dietary interventions, no clear difference in performance was seen consistently across all outcome measures.
Therefore, choice of delivery style can not be specified by the results of this study. The multitude and complexity of factors involved in dietary behaviour change and achievement of positive outcomes is supported and reinforced. Some associations between initial characteristics and final outcomes were suggested and further studies are recommended to clarify and explore these findings further. The results of this study indicate that the most feasible and outcome effective style of delivery for this target population is dependent on the individual's capacity to participate, their initial anthropometric, clinical, behavioural and psychosocial profile, and other factors such as their support network, and physical and mental status. A screening process to select the most appropriate form of dietary intervention for individual clients with heart disease was developed to assist practitioners in the clinical setting.
Due to changes in knowledge scores during the study and the high percentage of participants meeting desirable outcome criteria before intervention, the validity and usefulness of some of the outcome measures can be questioned. For example, the focus on reducing fat intake was not appropriate as many were already selecting a low fat diet. The study also highlighted the need for practitioners to focus more on the dietary fibre intake of participants and their perceived barriers to change, for example, their willingness to explore new foods. High scores for doctors in the health locus of control questionnaires demonstrated the important role doctors are perceived to play, and hence their inclusion and involvement to promote a collaborative and integrated team approach is encouraged. The importance of ongoing support and follow-up for these clients was also highlighted and recommended.
The education resource developed for use in the current study will provide a useful tool for clinicians providing dietary and lifestyle education to men with coronary heart disease. The proposed screening process and recommendations are also provided for dissemination to, and evaluation by, practitioners. Further research is encouraged to build upon these findings and continue contributing towards the development of best practice guidelines for the dietary management of clients with heart disease.
3
Brownson, Deborah Ann. "The use of classroom environment improvement plans in an attempt to change aspects of teacher interpersonal behaviour and the science laboratory learning environment in order to improve student outcomes." Thesis, Curtin University, 2006. http://hdl.handle.net/20.500.11937/1875.
Анотація:
The learning environment has been the focus of considerable educational research over a long period of time. The study reported in this thesis utilises the perceptions of 208 junior science students from a North Queensland state secondary school to inform classroom environment improvement plans developed and implemented by their teachers' in an attempt to improve the cognitive and attitudinal outcomes of the students. The five stage process on which the study is based combines theory and practice in providing the participating teachers with a structured means of bringing about change in their classrooms. Students' perceptions of actual and preferred teacher interpersonal behaviour and the laboratory learning environment are measured using the QTI and SLEI respectively. Particular aspects of teacher interpersonal behaviour and the laboratory learning environment are targeted for change through the classroom environment improvement plans. The study identified which aspects of the learning environment had changed after a period of intervention. It also identified associations between students' perceptions of aspects of their laboratory learning environment and attitudinal outcomes as well as associations between teacher interpersonal behaviours and attitudinal outcomes. While no direct associations were found between aspects of the laboratory learning environment or teacher interpersonal behaviours and cognitive outcomes, students' cognitive outcomes did improve over the duration of the study thus supporting a previously established link between student attitudes and cognitive outcomes.
4
Brownson, Deborah Ann. "The use of classroom environment improvement plans in an attempt to change aspects of teacher interpersonal behaviour and the science laboratory learning environment in order to improve student outcomes." Curtin University of Technology, Science and Mathematics Education Centre, 2006. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=17767.
Анотація:
The learning environment has been the focus of considerable educational research over a long period of time. The study reported in this thesis utilises the perceptions of 208 junior science students from a North Queensland state secondary school to inform classroom environment improvement plans developed and implemented by their teachers' in an attempt to improve the cognitive and attitudinal outcomes of the students. The five stage process on which the study is based combines theory and practice in providing the participating teachers with a structured means of bringing about change in their classrooms. Students' perceptions of actual and preferred teacher interpersonal behaviour and the laboratory learning environment are measured using the QTI and SLEI respectively. Particular aspects of teacher interpersonal behaviour and the laboratory learning environment are targeted for change through the classroom environment improvement plans. The study identified which aspects of the learning environment had changed after a period of intervention. It also identified associations between students' perceptions of aspects of their laboratory learning environment and attitudinal outcomes as well as associations between teacher interpersonal behaviours and attitudinal outcomes. While no direct associations were found between aspects of the laboratory learning environment or teacher interpersonal behaviours and cognitive outcomes, students' cognitive outcomes did improve over the duration of the study thus supporting a previously established link between student attitudes and cognitive outcomes.
5
Shao, Jung-Hua. "Evaluation of health-related outcomes following a self-management program for older people with heart failure." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/20702/1/Jung-Hua_Shao_Thesis.pdf.
Анотація:
Background. Heart failure (HF) which is a chronic, disabling disorder is mainly found in older people and is one of the leading causes of hospitalisation and readmission around the world. Unfortunately, the mortality and morbidity rates for HF remain high. HF is a complex combination of symptoms which are related to an inadequate perfusion of the body tissues caused by fluid and sodium retention. Hence, enhancing HF patients’ self-efficacy to change their behaviours to perform fluid & sodium control is one of the most important issues for the management of HF. A self-management program has the potential to raise self-efficacy and self-care which is a method to improve health for those with chronic illness and to decrease patients’ health service utilisation and also to enhance these patients’ health status. Aim. The study aims to examine the effectiveness of a self-management program, based on self-efficacy theory, in older people with heart failure in Taiwan. Methods. An experimental design was used to examine the effectiveness of a self-management program on diet and fluid control among HF patients. A total of 93 subjects from two medical centres in Taiwan were randomly assigned to the intervention and control groups. In order to examine the effectiveness of self-management, data were collected at baseline, week 4, and week 12 using the following instruments: self-efficacy for salt and fluid control, HF self-management behaviour, HF related symptoms, and body weight. Moreover, health service utilisation and patient’s evaluation of care received were collected on all patients for the 12 weeks prior to commencing the study and for the 12 week study period. Demographic and disease information was also collected including age, gender, marital state, education, and New York Heart Association (NYHA) functional classification. A structured, individualized self-management training program created by the investigator was implemented for the intervention group through home visits and telephone follow-ups. This program emphasized self-monitoring of diet control and body weight for the self-management of heart failure. The purpose was to improve patients’ self-efficacy in their diet control behaviour. The “diet control” in this study focussed on sodium and fluid restriction. Outcome measures were analysed using the Statistical Package for the Social Sciences (SPSS) 15.0 version, and the level of significance (á) was set at 0.05 for statistical analysis. Results. There were differences for older Taiwanese HF patients’ self-efficacy for salt and fluid control, self-management behaviour, and HF related symptoms for participants who received a self-management intervention compared to those who did not. However, there were no significant differences between the two groups in weight and health serves utilization (p>.001). Conclusion. The self-management program had a positive impact on the improvement of self-efficacy for salt and fluid control, HF related self-management behaviours and symptoms in older Taiwanese with HF. This program may bridge the gap between theory and practice. Health care providers need to provide older people in Taiwan with HF the appropriate skills for self-managing their condition and thereby promoting their health status. These patients with HF and their caregivers have to receive individualized education that emphasizes self-efficacy in the self-management of their disease, thus improving their quality of life.
6
Shao, Jung-Hua. "Evaluation of health-related outcomes following a self-management program for older people with heart failure." Queensland University of Technology, 2008. http://eprints.qut.edu.au/20702/.
Анотація:
Background. Heart failure (HF) which is a chronic, disabling disorder is mainly found in older people and is one of the leading causes of hospitalisation and readmission around the world. Unfortunately, the mortality and morbidity rates for HF remain high. HF is a complex combination of symptoms which are related to an inadequate perfusion of the body tissues caused by fluid and sodium retention. Hence, enhancing HF patients’ self-efficacy to change their behaviours to perform fluid & sodium control is one of the most important issues for the management of HF. A self-management program has the potential to raise self-efficacy and self-care which is a method to improve health for those with chronic illness and to decrease patients’ health service utilisation and also to enhance these patients’ health status. Aim. The study aims to examine the effectiveness of a self-management program, based on self-efficacy theory, in older people with heart failure in Taiwan. Methods. An experimental design was used to examine the effectiveness of a self-management program on diet and fluid control among HF patients. A total of 93 subjects from two medical centres in Taiwan were randomly assigned to the intervention and control groups. In order to examine the effectiveness of self-management, data were collected at baseline, week 4, and week 12 using the following instruments: self-efficacy for salt and fluid control, HF self-management behaviour, HF related symptoms, and body weight. Moreover, health service utilisation and patient’s evaluation of care received were collected on all patients for the 12 weeks prior to commencing the study and for the 12 week study period. Demographic and disease information was also collected including age, gender, marital state, education, and New York Heart Association (NYHA) functional classification. A structured, individualized self-management training program created by the investigator was implemented for the intervention group through home visits and telephone follow-ups. This program emphasized self-monitoring of diet control and body weight for the self-management of heart failure. The purpose was to improve patients’ self-efficacy in their diet control behaviour. The “diet control” in this study focussed on sodium and fluid restriction. Outcome measures were analysed using the Statistical Package for the Social Sciences (SPSS) 15.0 version, and the level of significance (á) was set at 0.05 for statistical analysis. Results. There were differences for older Taiwanese HF patients’ self-efficacy for salt and fluid control, self-management behaviour, and HF related symptoms for participants who received a self-management intervention compared to those who did not. However, there were no significant differences between the two groups in weight and health serves utilization (p>.001). Conclusion. The self-management program had a positive impact on the improvement of self-efficacy for salt and fluid control, HF related self-management behaviours and symptoms in older Taiwanese with HF. This program may bridge the gap between theory and practice. Health care providers need to provide older people in Taiwan with HF the appropriate skills for self-managing their condition and thereby promoting their health status. These patients with HF and their caregivers have to receive individualized education that emphasizes self-efficacy in the self-management of their disease, thus improving their quality of life.
7
Andersson, Jonas. "Effects of parent training on parenting: : Associated Change between Parental Behaviors and Preadolescent Problem Behaviors." Thesis, Örebro universitet, Akademin för juridik, psykologi och socialt arbete, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-26385.
Анотація:
The aim of this study was to find out if change in parent behavior is associated with change in preadolescent problem behavior during parent training programs. A total of 561 single parents or couples of mainly Swedish origin were randomized into one out of four parent training programs with different theoretical bases. Parents’ self-reports of their own behavior and of their children’s intensity as well as impact of problem behavior, lack of attention, and hyperactivity showed that effects were equal across interventions for both children and parents. 12 parent constructs were measured. All of them except positive parent behavior constructs correlated with all four outcomes for children on significant levels. Negative parent behavior predicted change in all child outcomes on a highly significant level.
8
Neame, Margo Elizabeth Elwin. "Process of health behaviour change: Is Change Talk associated with diabetes outcome? A pilot study of Motivational Interviewing." Thesis, University of Canterbury. Psychology, 2012. http://hdl.handle.net/10092/7503.
Анотація:
Motivational Interviewing (MI) is a person-centred and collaborative form of guiding individuals to elicit and strengthen their motivation for change. It has achieved success in the treatment of substance disorders, and has shown promise in several other areas of interest, such as behaviour management in chronic illness. The process through which MI exerts its influence on outcome however, is still in its infancy.
This research set out to explore the nature of Type 1 and Type 2 diabetes patients‟ utterances in Motivational Enhancement Therapy (MET) sessions (Change Talk), and the associations between their Change Talk and diabetes outcome (clinically significant change in blood glucose levels). Data for this study was taken from a multiple baseline designed study in a diabetes clinic in Christchurch (Britt, 2008). Nine patients who were referred to the clinic for help with their diabetes self-management were administered MET by Diabetes Nurse Educators (DNEs) which comprised four sessions over a six week period. In the current study participants were divided into those who did (BG Change participants; n = 4) or those who did not (BG No Change participants; n = 5) achieve a clinically significant change in their blood glucose levels (HbA1c) post intervention. All client utterances from the 36 transcripts were coded with the Motivational Interviewing Skills Code, version 2.0 (MISC, 2.0), and data analysed accordingly.
This is a unique study in that it investigated both the mean frequency and strength of Change Talk in the different participant sets, as well as their patterns of Change Talk within and across sessions. Trends and directions in data suggest support for parts of the theory of the inner workings of MI. In particular, the BG Change participants uttered stronger Desire Language, a higher frequency of Commitment language, and weaker Ability language than
the BG No Change participants. In addition, a general increasing pattern of strength across and within sessions, and frequency across sessions was found for the BG Change participants, while a similar pattern was found for the BG No Change participants regarding strength, but not frequency. The role of Sustain Talk strength and its relationship to the findings is highlighted. Implications of findings, as well as limitations of the current research and suggestions for future areas of research are discussed.
9
Rudge, Marion. "An Exploratory Analysis of Change During Group CBT for Social Phobia in Clinical Practice: A Treatment-Effectiveness Study." Thesis, University of Canterbury. Psychology, 2007. http://hdl.handle.net/10092/1417.
Анотація:
The effectiveness of a Group CBT programme for Social Phobia was assessed using 18 participants recruited from a routine practice setting. Therapy was based on CBT techniques as practiced routinely by the clinical practice, and were not modified for the study by factors such as strict exclusion criteria and adherence to rigid manualised treatments. Pre- to post-treatment effect sizes compared favourably with those reported in a meta-analysis (Taylor, 1996). The findings provide support for the accessibility and effectiveness of group CBT techniques for Social Phobia in field settings. While some individuals within the sample experienced dramatic improvement, some remained severely impaired even at post-treatment. The results of Hierarchical Multiple Regressions indicated that lower levels of pre-treatment depression severity, higher levels of attendance, and greater homework compliance, were predictive of more improvement on some, but not all, measures of outcome. Implications for treatment are discussed.
10
Ellison, Adrian Bachman. "Evaluating changes in driver behaviour for road safety outcomes: a risk profiling approach." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/11567.
Анотація:
Road safety continues to be an important issue with road crashes among the leading causes of death. Considerable effort has been put into improving our understanding of the factors that influence driving behaviour with a view to devising more effective road safety strategies. Within the literature, demographics, social norms, personality, enforcement and the road environment have all been identified as influencers of risky driving behaviour. What is missing is an integrated empirical approach which examines the relationship between these factors and drivers’ awareness of their speeding behaviour to a measure of day-to-day driving behaviour. This research employs demographic, psychological, vehicle, trip and Global Positioning System (GPS) driving data collected from 106 drivers in Sydney, Australia during a pay-as-you-drive study. The main contributions are three-fold. First, a methodology is developed to control for the influence of spatiotemporal characteristics on driver behaviour. This deals with the inherent variability introduced from road environment factors external to the driver which would otherwise lead to misleading results. Second, the creation of a composite measure of driver behaviour allows driver behaviour to be described using a single measure whilst accounting for the variability and multitude of aspects within the driving task. This allows drivers to be compared to each other and for the same driver to be compared across time and space permitting empirical testing of interventions in a before and after study. Lastly, this research reveals the potential for reducing the extent and magnitude of risky driving behaviour by making drivers aware of their own behaviour. The results indicate that drivers can be placed in three groups: drivers requiring a monetary incentive to change speeding behaviour, drivers requiring information alone to change their speeding behaviour and drivers that appear unresponsive to both monetary incentives and information.
11
Gethin-Jones, Rachel. "The impact of employee perceptions and organisation-related employee attributes on employee outcomes after restructuring /." St. Lucia, Qld, 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17814.pdf.
12
Jones, Holly. "Exploration of predictors, moderators and mediators of change in parent skills training programmes for externalising behaviour problems in children : who benefits most and how do they work?" Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/28690.
Анотація:
Background: A key driver for early years strategies is the reduction of oppositional and defiant behaviour in childhood to prevent a negative life course of poor educational attainment and criminality. Despite a robust evidence base, manualised parent skills training programmes (PT) for externalising behaviour problems are only effective for approximately two-thirds of families. A limited number of variables that account for variance in outcome have been discovered. Finding further predictor, moderator and mediator variables will explain who benefits most, and how change occurs. This will ensure that families receive the most appropriate treatments for their profile of needs, and services deliver the available interventions in an efficient and effective way. Objectives: A systematic review of the literature was conducted to explore progress in this area since two key meta-analyses published in 2006. A primary study was carried out to examine whether parent attachment style, parenting self-efficacy and dysfunctional parental attributions predict, moderate or mediate the levels of externalising child behaviour problems reported by parents attending the Incredible Years PT. Methods: Studies exploring variables influencing outcome in child behaviour following attendance at a manualised, evidence-based PT group for parents of children and adolescents aged 0-18 years were sought. Psychinfo, Medline, ERIC and Embase databases were searched for articles published between August 2004 and March 2013 with keywords ‘parent’, ‘child’, ‘training’, ‘indirect effects’ and ‘oppositional behaviour’ or related terms. 2853 articles were retrieved, from which 12 studies fulfilled criteria. Study quality was appraised and co-rated. A pre-post, within subjects design was conducted with 79 parents attending the Incredible Years PT delivered in a Child and Adolescent Mental Health Service. Participants completed a battery of pre-treatment questionnaires measuring attachment style, attributions, self-efficacy and child behaviour. 52 parents completed the same battery post-treatment, and missing data was carried forward in an intent to treat analysis. Data was analysed using multiple regression techniques, and mediation and moderated mediation analyses. Results: The recent evidence base is populated by secondary analyses of intervention RCTs, and less robust non RCTs. The selection of maternal mood, parenting stress, parenting style and child demographics dominate, and the exploration of unique variables is limited. Significant findings are mixed and add no new variables to our understanding. Significant changes in parenting self-efficacy and dysfunctional attributions were found post-treatment, and attachment style remained stable. A main treatment effect size of d=.3 was estimated, and a significant number of children fell below sub-clinical levels of problem behaviour (n=13, 15.7%). Baseline child-responsible attributions and self-efficacy accounted for up to 40% of the variance in baseline child behaviour. Attachment style did not contribute significantly to the model, but moderated parent-causal attributions. Post-treatment, attachment avoidance had a moderating effect on self-efficacy and child-responsible attributions, and a significant direct effect on outcome. The indirect effect of parental-attributions on child behaviour through self-efficacy was moderated by attachment avoidance which reduced the number of significant paths. Conclusions: The call for PT studies delivered with fidelity in real world settings has been recognised, and more sophisticated statistical models of mediation are being adopted. There remains an exhaustive list of novel potential variables that future research needs to select and explore in primary research designs. An evidence based PT is achieving statistically and clinically significant results for children referred for problem behaviour. Dysfunctional parent attributions and self-efficacy are predictors of both pre- and post-treatment levels of child behaviour, which could be screened for in the referral process. The evidence for a direct and indirect role of attachment style on parent training outcomes adds a new candidate variable to the literature that warrants further exploration.
13
Befile, Nomawethu. "The relationship between organisational culture, transformational leadership and organisational change outcomes in public intensive care units." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/14576.
Анотація:
Organisational change in any organisation, including the healthcare industry, implies a change in organisational culture. The concept of organisational culture refers to those values and norms within an organisation that are prescribed by both the employer and the employees as to how to behave. However, organisational culture should not be viewed in isolation, as culture and leadership are intertwined. Transformational leadership within an organisational culture serves to achieve its goal, missions and aims by influencing, motivating and creating a mutual relationship between employees and employers, which brings about effective organisational change. The alignment of organisational culture and leadership with a hospital’s vision is important to ensure optimal healthcare delivery and organisational change outcomes. A positivistic research paradigm, with a quantitative, explorative, descriptive and contextual approach, was used to conduct the research study. The research study explored whether a supportive organisational culture, transformational leadership and organisational change outcomes were prevalent in public intensive care units. Secondly, the study aimed to investigate the relationship between organisational culture, transformational leadership and organisational change outcomes in public intensive care units in the Nelson Mandela Bay. Data was collected by means of a structured and previously validated questionnaire with a Cronbach’s alpha of more than 0.80. The target population was registered nurses who work in the intensive care units in the public hospitals. The sample was composed of 56 registered nurses and 4 enrolled nurses who were selected from public hospital intensive care units in Nelson Mandela Bay. Descriptive statistics, linear regression analysis, correlation and a Chi-square test were used to describe the hypothesised relationship between organisational culture and transformational leadership (independent) with organisational change outcomes (dependent variable). The results of this study revealed that the alternative hypothesis was accepted as the P value, was less than 0.05 in all variables. This proved that there was a significant relationship between organisational culture, transformational leadership and organisational change outcomes in the public intensive care units which were sampled. Recommendations are made as to how organisational culture can enhance and support transformational leadership and organisational change outcomes to promote a positive change outcome in public intensive care units. Ethical considerations were maintained throughout the research study.
14
Dum, Mariam. "A Longitudinal Approach to Understanding Individual Differences Affecting the Drinking Behavior Change Process." Diss., NSUWorks, 2009. https://nsuworks.nova.edu/cps_stuetd/27.
Анотація:
Most studies examining predictors of treatment outcomes among problem drinkers have used a traditional statistical approach that examines group outcomes (e.g. analysis of variance, multiple regression analysis). Contrary to traditional methods, a person-centered approach identifies commonalities among clusters of individuals and provides the opportunity to examine the relationship between multiple individual differences and outcomes in a longitudinal manner. Specifically, the person-centered approach makes it possible to cluster individuals into subgroups based on their change patterns, and to examine the relationship between those subgroups and other variables of interest (e.g., drinking problem severity). This approach allows the inclusion of a relatively large number of variables to test complex hypotheses. The present study is a secondary data analysis of early (first three-month) Timeline Followback (TLFB) post-treatment drinking data from 200 problem drinkers who completed a short outpatient intervention. Using a growth mixture modeling (GMM) analysis, the goal was to identify different outcome drinking trajectories and examine the relationship between problem severity levels, treatment modality (i.e. individual versus group format), and goal choice (i.e. low-risk drinking versus abstinence) to those trajectories. Results demonstrated the existence of different outcome subgroups among problem drinkers. In addition, problem severity level was associated with outcomes and class membership. Observed significant differences in the relationships between predictor variables and specific outcome subgroups, and evidence of different drinking fluctuation patterns in the outcomes suggest that using a person-centered approach adds value beyond traditional statistical outcome analyses. The person-centered approach can facilitate the identification of relevant variables for patient-treatment matching hypotheses for problem drinkers.
15
Freeman, James Edwin. "Influencing recidivist drink drivers' entrenched behaviours : the self-reported outcomes of three countermeasures." Thesis, Queensland University of Technology, 2004. https://eprints.qut.edu.au/15927/3/James_Freeman_Thesis.pdf.
Анотація:
Concern remains regarding the efficacy of drink driving countermeasures to produce lasting change for repeat offenders, as a wide array of countermeasures have been developed that demonstrate varying levels of success in reducing re-offence rates. This thesis proposes that the collection and examination of repeat offenders' self-reported perceptions, experiences and behavioural changes that result from completing court-ordered interventions can provide valuable contributions to the development of effective sentencing strategies. As a result, the program of research implemented a mixed-method design to investigate the self-reported impact of legal sanctions, a drink driving rehabilitation program, and alcohol ignition interlocks on key outcome measures for a group of recidivist drink drivers.-----
Study One incorporated a cross-sectional design to examine the deterrent effect of traditional legal sanctions (e.g., fines and licence disqualification periods), non-legal sanctions, alcohol consumption, recent offending behaviour(s), and the actual severity of sanctions on perceptual deterrence and intentions to re-offend. The study involved face-to-face and telephone interviews with 166 repeat offenders. The analysis indicated that participants perceived legal sanctions to be severe, but not entirely certain nor swift.-----
In Study One, self-reported recent drink driving behaviours and alcohol consumption levels were identified as predictors of future intentions to drink and drive. The results suggest that habitual behaviours are difficult to change, and heavy alcohol consumption levels increase the probability of re-offending. At a bivariate level, three non-legal sanctions were negatively associated with intentions to re-offend but were not predictors of future intentions to drink and drive in the model. In addition, a relationship was not evident between: (a) the size of the penalties and perceptions of sanction severity or future intentions to drink and drive, and (b) the number of previous convictions and self-reported deterrence. The findings of the study confirm the popular assumption that some repeat offenders are impervious to the threat and application of legal sanctions.-----
Study Two examined the stages of change and self-efficacy levels of 132 repeat offenders - who were all involved in Study One - while they completed an 11 week drink driving rehabilitation program. A repeated measures design was implemented to focus on the impact of the intervention on a number of salient program outcomes such as participants' motivations and self-efficacy levels to control and change their drinking and drink driving behaviour(s). Prior to program commencement, the majority of participants were motivated to change their drinking driving, but not their drinking. The sample also reported high self-efficacy levels to control the two behaviours, but did not have high expectations of the effectiveness of the program.-----
Upon completion of the program, significant increases were evident in motivations to change drinking and drink driving behaviours, and a large percentage of participants reported a positive appraisal of the effectiveness of the intervention. Program completion also resulted in a reduction in self-reported alcohol consumption levels, yet the majority of the sample continued to consume harmful levels of alcohol. Self-efficacy levels remained high, although a notable finding was that participants reported higher levels of control over their drinking rather than drink driving behaviours. In general, Study Two provided a positive perspective of the capacity of a drink driving rehabilitation program to produce change for a group of repeat offenders.-----
Study Two extended a small body of research and examined the effects that mandated program enrolment has on motivations to change, as well as expectations and appraisals of program effectiveness. Contrary to predictions, mandated participants did not report lower levels of motivation to change drinking and drink driving compared to voluntary attendees, but did indicate lower expectations of the effectiveness of the program, as well as being willing to engage in the program. Furthermore upon program completion, mandated participants also reported lower appraisals of the effectiveness of the program, but this factor was not associated with intentions to re-offend or non-program completion. Rather, not successfully completing the program appeared linked with being unwilling to change drinking behaviours.-----
Study Three involved a longitudinal case-study design that utilised both quantitative and qualitative data to conduct one of the first examinations of the impact of alcohol ignition interlocks on a group of recidivist drink drivers from a users' perspective. The study investigated 12 participants' self-reported perceptions and experiences of using an interlock and the effect that the device had on key program outcomes such as drinking levels, operational performance, circumvention attempts and general beliefs regarding the effectiveness of the device in comparison to traditional legal sanctions.-----
Participants reported positive appraisals regarding the effectiveness of the device as qualitative themes emerged concerning the educational and practical benefits of interlocks. However, closer examination of individual interlock performances revealed each participant had attempted to start their vehicle after consuming alcohol, and a smaller sample of three drivers were regularly attempting to start their vehicle after drinking. The combination and analysis of self-reported and downloaded interlock data revealed four main themes: (a) initial operational difficulties, (b) a general unwillingness to reduce alcohol consumption levels, (c) an unwillingness to acknowledge/recognise that interlock breath violations resulted from drinking, and (d) an overall decline in the frequency of interlock breath violations over the interlock installation period. Similar to Study Two, a notable finding was that half the sample was still consuming harmful levels of alcohol upon program completion.-----
Taken together, the results of the program of research highlight that repeat offenders' entrenched behaviours, such as drinking and drink driving, are resistant to change and that multi-modal interventions are required if the drinking and driving sequence is to be broken for this population. The findings have direct implications for the sentencing and management of repeat offenders and the development of countermeasures that attempt to produce long-term behavioural change.
16
Freeman, James Edwin. "Influencing recidivist drink drivers' entrenched behaviours : the self-reported outcomes of three countermeasures." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15927/.
Анотація:
Concern remains regarding the efficacy of drink driving countermeasures to produce lasting change for repeat offenders, as a wide array of countermeasures have been developed that demonstrate varying levels of success in reducing re-offence rates. This thesis proposes that the collection and examination of repeat offenders' self-reported perceptions, experiences and behavioural changes that result from completing court-ordered interventions can provide valuable contributions to the development of effective sentencing strategies. As a result, the program of research implemented a mixed-method design to investigate the self-reported impact of legal sanctions, a drink driving rehabilitation program, and alcohol ignition interlocks on key outcome measures for a group of recidivist drink drivers.-----
Study One incorporated a cross-sectional design to examine the deterrent effect of traditional legal sanctions (e.g., fines and licence disqualification periods), non-legal sanctions, alcohol consumption, recent offending behaviour(s), and the actual severity of sanctions on perceptual deterrence and intentions to re-offend. The study involved face-to-face and telephone interviews with 166 repeat offenders. The analysis indicated that participants perceived legal sanctions to be severe, but not entirely certain nor swift.-----
In Study One, self-reported recent drink driving behaviours and alcohol consumption levels were identified as predictors of future intentions to drink and drive. The results suggest that habitual behaviours are difficult to change, and heavy alcohol consumption levels increase the probability of re-offending. At a bivariate level, three non-legal sanctions were negatively associated with intentions to re-offend but were not predictors of future intentions to drink and drive in the model. In addition, a relationship was not evident between: (a) the size of the penalties and perceptions of sanction severity or future intentions to drink and drive, and (b) the number of previous convictions and self-reported deterrence. The findings of the study confirm the popular assumption that some repeat offenders are impervious to the threat and application of legal sanctions.-----
Study Two examined the stages of change and self-efficacy levels of 132 repeat offenders - who were all involved in Study One - while they completed an 11 week drink driving rehabilitation program. A repeated measures design was implemented to focus on the impact of the intervention on a number of salient program outcomes such as participants' motivations and self-efficacy levels to control and change their drinking and drink driving behaviour(s). Prior to program commencement, the majority of participants were motivated to change their drinking driving, but not their drinking. The sample also reported high self-efficacy levels to control the two behaviours, but did not have high expectations of the effectiveness of the program.-----
Upon completion of the program, significant increases were evident in motivations to change drinking and drink driving behaviours, and a large percentage of participants reported a positive appraisal of the effectiveness of the intervention. Program completion also resulted in a reduction in self-reported alcohol consumption levels, yet the majority of the sample continued to consume harmful levels of alcohol. Self-efficacy levels remained high, although a notable finding was that participants reported higher levels of control over their drinking rather than drink driving behaviours. In general, Study Two provided a positive perspective of the capacity of a drink driving rehabilitation program to produce change for a group of repeat offenders.-----
Study Two extended a small body of research and examined the effects that mandated program enrolment has on motivations to change, as well as expectations and appraisals of program effectiveness. Contrary to predictions, mandated participants did not report lower levels of motivation to change drinking and drink driving compared to voluntary attendees, but did indicate lower expectations of the effectiveness of the program, as well as being willing to engage in the program. Furthermore upon program completion, mandated participants also reported lower appraisals of the effectiveness of the program, but this factor was not associated with intentions to re-offend or non-program completion. Rather, not successfully completing the program appeared linked with being unwilling to change drinking behaviours.-----
Study Three involved a longitudinal case-study design that utilised both quantitative and qualitative data to conduct one of the first examinations of the impact of alcohol ignition interlocks on a group of recidivist drink drivers from a users' perspective. The study investigated 12 participants' self-reported perceptions and experiences of using an interlock and the effect that the device had on key program outcomes such as drinking levels, operational performance, circumvention attempts and general beliefs regarding the effectiveness of the device in comparison to traditional legal sanctions.-----
Participants reported positive appraisals regarding the effectiveness of the device as qualitative themes emerged concerning the educational and practical benefits of interlocks. However, closer examination of individual interlock performances revealed each participant had attempted to start their vehicle after consuming alcohol, and a smaller sample of three drivers were regularly attempting to start their vehicle after drinking. The combination and analysis of self-reported and downloaded interlock data revealed four main themes: (a) initial operational difficulties, (b) a general unwillingness to reduce alcohol consumption levels, (c) an unwillingness to acknowledge/recognise that interlock breath violations resulted from drinking, and (d) an overall decline in the frequency of interlock breath violations over the interlock installation period. Similar to Study Two, a notable finding was that half the sample was still consuming harmful levels of alcohol upon program completion.-----
Taken together, the results of the program of research highlight that repeat offenders' entrenched behaviours, such as drinking and drink driving, are resistant to change and that multi-modal interventions are required if the drinking and driving sequence is to be broken for this population. The findings have direct implications for the sentencing and management of repeat offenders and the development of countermeasures that attempt to produce long-term behavioural change.
17
Henderson, Alicia Ann. "Parenting Skills as Predictors of Child and Adolescent Psychotherapy Outcomes: Examining Change in Usual Care Settings." BYU ScholarsArchive, 2013. https://scholarsarchive.byu.edu/etd/4268.
Анотація:
Youth psychotherapy literature is in need of more research related to understanding psychotherapy process and outcome in child psychotherapy in community settings. The purpose of this study was to examine how key parenting skills were associated with child and adolescent symptoms and outcomes over the course of treatment in an outpatient community mental health system. Much of the research on child and adolescent outcomes has been conducted in controlled research settings, which raises the importance of more research needing to be done in representative clinical practice conditions (Weisz & Jensen, 2001). Further, few child and adolescent studies have examined potential mechanisms of change in child and adolescent psychotherapy (Kazdin & Nock, 2003), including moderators and mediators of the relation between parenting skills and child and adolescent outcomes.Participants included 407 youth, ages 4-17 (mean age = 9.7 years), and their parents or guardians, receiving routine outpatient mental health services in a community mental health setting. The youth sample included 51% males, 49% females. Measures used included the Youth Outcome Questionnaire (Y-OQ; Burlingame, Wells, Lambert, & Cox, 2004; Burlingame et al., 2001), and the Treatment Support Measure (TSM). Data were collected starting at the intake session, each of the first five therapy sessions, then every three weeks thereafter for six months post-intake. Parenting Skills items from the TSM included domains of overreactivity, laxness, verbosity, monitoring, consistency, and positive reinforcement. Hierarchical linear modeling was used to examine changes in parenting behaviors and youth symptoms. Results indicated that parenting skills significantly improved over the course of treatment (p < .001) and best fit a logarithmic (natural log) function, such that most of the reported change in parenting skills occurred during the first few sessions of treatment. Further, there was a significant inverse relationship at intake between parenting skills and Y-OQ scores; specifically, lower parenting skills scores were associated with higher Y-OQ scores for parent and youth report (p < .001; p = .033). In addition, parenting skills at intake were associated with the subsequent rate of change of youth symptoms for parent report (p < .001) and youth report (p = .026). Lastly, improvements in parenting scores were associated with improved youth symptoms over the course of treatment for parent and youth report of symptoms (p = .021; p = .02). These findings can be generalized to other community outpatient settings and highlight the importance of attending to parenting skills as an avenue to improving child psychotherapy outcomes. Specifically, the results of this study emphasize the importance of parents implementing effective parenting skills and its influence on their child's overall symptoms at intake and outcomes in therapy.
18
Martinez, Stephanie Angelique. "School-Wide PBS: The Link Between Action Planning and Outcomes." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3235.
Анотація:
Most school based initiatives are not implemented long-term and do not reach sustainability (McDermott, 2000; Mirel, 1994; Rice & Malen, 2003). Schools are implementing School-Wide Positive Behavior Support (SWPBS) as an initiative to target social emotional development and behavior. Schools that have implemented SWPBS have experienced decreases in rate of Office Discipline Referrals (ODR), In-School Suspension (ISS) and Out-of-School Suspension (OSS) (e.g. Bohanon et al., 2006; Childs et al., 2009; Lassen et al., 2006). Research has also shown that schools that implement with a higher degree of fidelity have better outcomes (Childs et al., 2009; Florida's Positive Behavior Support Project, 2009). However, it is not known what mediating factor(s) assist with schools with implementation of Tier 1 PBS at a higher degree of fidelity.
This study examined action plans that schools developed during their initial training of Tier 1 PBS, to determine if the action plans are one of the possible mediating factor(s). There are differences between the quality of action plans developed by schools implementing with a higher degree of fidelity compared to schools implementing with a lower degree of fidelity. Based on a path analysis, the action plans are not a mediating factor between fidelity of implementation and student outcomes (i.e. office discipline referrals, In-School Suspension, and Out-of-School Suspension).
19
Shiau, Shujen. "The mediating effect of maternal-child coping behaviors on child adaptational outcome : an ecological approach /." Thesis, Connect to this title online; UW restricted, 1989. http://hdl.handle.net/1773/7349.
20
Eichaker, Lauren R. "Injury Mechanisms and Outcomes in Lead Vehicle Stopped, Near Side, and Lane Change-Related Impacts: Implications for Autonomous Vehicle Behavior Design." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1500330466825096.
21
Ramnerö, Jonas. "Behavioral Treatments of Panic Disorder with Agoraphobia : Treatment Process and Determinants of Change." Doctoral thesis, Stockholm University, Department of Psychology, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-404.
Анотація:
The present dissertation comprises four empirical studies within the area of behavioral treatment of panic disorder with agoraphobia. The focus is on studying issues pertaining to outcome, treatment process and determinants of change. The first study is a randomized controlled treatment study of 73 patients undergoing 16 sessions of either exposure in vivo (E), or cognitive behavior therapy (CBT). Both treatments showed clear improvements at post-treatment that were well maintained at 1-year follow up, and there were no significant differences between the treatments.
The second study concerned prediction of outcome in the same sample. From a variety of pre-treatment characteristics severity of avoidance was the one most related to outcome. Most predictors were found unrelated. Two approaches of prediction were also compared: treating outcome as a categorical vs. continuous variable. The different approaches yielded a somewhat dissimilar picture of the impact of pre-treatment severity of avoidance. The third study examined different aspects of the therapeutic relationship, and their relation to outcome. Clients’ perceptions of therapists and their ratings of the working alliance were generally not related to outcome at any point. On the other hand, therapists’ perceptions of patients as showing goal-direction and active participation were related to outcome from early on in therapy. The fourth study examined different aspects of change. It was found that change in indices of the frequency of panic attacks was not closely related to change in agoraphobic avoidance at post-treatment. Change in avoidance was also more related to other aspects of outcome. At one-year follow-up, a more unitary picture, regarding the different aspects of change was observed.
22
Campbell, Samadhi Deva. "Process of Motivational Enhancement Therapy: Relationships between Therapist and Client Behaviours, and Alcohol Use Outcome." Thesis, University of Canterbury. Psychology, 2007. http://hdl.handle.net/10092/1414.
Анотація:
Motivational Interviewing (MI) is an evidence-based, directive, client-centered therapy designed to develop discrepancy and resolve ambivalence by eliciting and reinforcing client Change Talk. However, the exact link between the process engaged in during MI and outcome is only starting to be uncovered. The present thesis has replicated and expanded on the current knowledge of the relationship between Therapist and Client Behaviours during a MI-based intervention (Motivational Enhancement Therapy; MET) and outcome, and has provided support for the emergent theory of the inner workings of MI. This was achieved by coding 106 audiotaped MET sessions primarily by the methods outlined in the Motivational Interviewing Skill Code Version 2.0. Data was drawn from 28 participants who received 3-4 sessions of MET within the context of a randomised controlled trial for mild-moderate alcohol dependence at the Community Alcohol and Drug Service of Christchurch. Therapist and Client Behaviours were analysed within sessions (categorised into Early, Mid, or End Intervals) and across sessions, and compared with whether the client had drank within national drinking guidelines during the 6-months after MET (Controlled Drinkers). In terms of Client Behaviours during MET it was found that Uncontrolled Drinkers (compared with Controlled Drinkers) uttered a significantly higher frequency of Sustain Talk, lower Ability Language strength (over all MET and during End Intervals), and lower Commitment Language strength (during Session 2 and 4, and change over MET). Giving Information was the only Therapist Behaviour where significant differences were observed over all MET, with a higher frequency given to the Uncontrolled Drinkers. However, during End Intervals within MET Sessions, Controlled Drinkers received a significantly higher frequency of Advise without Permission and a lower frequency of Emphasise Control statements. In most instances MI-Consistent Therapist Behaviours were associated with higher strength of Ability and Commitment Language, and a lower frequency of Sustain Talk. MI-Inconsistent Therapist Behaviour, Direct, was associated with lower Client Language strength. Limitations to these results include small sample, limited ability to make inferences about causality, coder biases, and uneven reliability. However, this exploratory study was unique in investigating the relationship between Therapist Behaviours and the strength of Client Language, and in examining these factors within and across multiple sessions, and has produced a number of potentially valuable findings that warrant further investigation.
23
Warner, Julie Anne. "An Outcome and Follow-up Evaluation of ‘Food Fit’: A Theory Based Childhood Overweight Prevention Curriculum." Columbus, Ohio : Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1243963290.
24
Reid, Natasha Elizabeth. "Improving Outcomes for Children with Fetal Alcohol Spectrum Disorders: An Investigation of Self-Regulation as a Potential Mechanism of Change." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/367266.
Анотація:
Fetal alcohol spectrum disorder (FASD) is a term used to indicate the range of conditions that can arise from prenatal exposure to alcohol. The pattern of central nervous system (CNS) dysfunction is somewhat variable by individual, but often involves impairments in learning and memory, self-regulation (including executive functions), social communication, and adaptive skills. Additionally, children with FASD often experience significant behavioural difficulties that impact on their functioning at home, school, and in community settings.
As a consequence, individuals with FASD are at a high-risk of experiencing secondary conditions, such as mental health problems, school disruption, and involvement with the criminal justice system, particularly as they enter adolescence. These neurocognitive difficulties, behaviour problems, and secondary conditions
contribute to the high burden for families raising children with FASD. Therefore, caregivers of children with FASD often experience higher levels of stress and increased risk of parent-child relationship difficulties.Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
School of Applied Psychology
Griffith Health
Full Text
25
Biddiscombe, Rachel, Justin Scanlan, and Jessica Ross. "Practical Food Groups: Exploring their contribution towards facilitating cognitive behavioural changes that suppport long term outcomes for individuals with eating disorders." Thesis, Discipline of Occupational Therapy, 2016. http://hdl.handle.net/2123/14324.
Анотація:
Objective: Relapse and rehospitalisation in individuals with eating disorders is a critical issue, especially considering their high prevalence. Emerging evidence supports practical and activity-based interventions as a potential treatment for long-term recovery. This study aimed to evaluate the contribution of "practical food groups" in facilitating cognitive and behavioural changes that support improved long-term outcomes for individuals with eating disorders. Method: Individuals with mixed diagnoses attended practical food groups as part of their treatment at an eating disorders day program. Ninety-nine participants completed questionnaires at discharge and three follow-up time points (6, 12 and 24 months). Questionnaires explored participants' experiences of practice food groups using rating-scale and open-ended responses. Data were collected between January 2010 and December 2014, and analysed using thematic analysis. Descriptive statistics were calculated for responses to rating-scale questions. Findings: At discharge, participants rated the importance and usefulness of practical food groups highly (4.73 and 44.43 on a 5-point scale, respectively), but tended to rate their enjoyment of the groups lower (3.50 on a 5-point scale). One core theme emerged: "success through participation". Six sub-themes were identified: helpful components of practical food groups; perceived benefit of exposure; impact of applying cognitive and behavioural skills; challenges affecting participation; facilitating adaptation; and influence of eating disorders on challenging feared foods. Discussion: This study highlighted that practical food groups are considered a useful, challenging and highly valued aspect of day treatment. Results support the potential usefulness of activity-based interventions to facilitate sustained change.
26
Ekmark, Lewén Sara. "Cellular Reactions and Behavioral Changes in Focal and Diffuse Traumatic Brain Injury : A Study in the Rat and Mouse." Doctoral thesis, Uppsala universitet, Neurokirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-177083.
Анотація:
Traumatic brain injury (TBI) is a severe condition and a major cause of death and disability. There is no pharmacological treatment available in clinical practice today and knowledge of brain injury mechanisms is of importance for development of neuroprotective drugs. The aims of the thesis were to get a better understanding of astrocyte reactions and immune responses, as well as behavioral changes after focal unilateral cortical contusion injury and diffuse bilateral central fluid percussion injury in rats and mice. In the focal injury models, the astrocyte reactions were generally restricted to the ipsilateral hemisphere. After diffuse TBI, vimentin and glial fibrillary acidic protein (GFAP) positive reactive astrocytes were bilaterally expressed in brain regions even distant from the injury site, including regions where axonal injury was seen. Early after diffuse TBI, there was a robust immune response, including activation of macrophages/microglia (Mac-2+) and infiltration of neutrophils (GR-1+) and T-cells (CD3+). In order to measure functional outcome, the recently established Multivariate Concentric Square Field™ (MCSF) test for complex behaviors, including risk taking and explorative strategies was used. The Morris water maze (MWM) was applied for testing learning and memory. The MCSF test revealed alterations in risk taking, risk assessment and exploratory behavior, in the mice subjected to focal injury whereas mice subjected to the diffuse injury showed a deviant stereotyped behavior. After focal injury mice showed a decreased ability to adapt to the arena in the second trial, when tested repeatedly in the MCSF test. Mice subjected to diffuse injury had an impaired memory but not learning, in the MWM test. Post-injury treatment with the anti-inflammatory anti-interleukin-1β (IgG2 a/k) antibody showed a positive effect on functional outcome in the diffuse injury model. Altogether, the results demonstrate that focal and diffuse TBI models produce differences in cellular reactions and behavioral outcome and that the immune response plays a key role in the pathology after brain injury.
27
Penley, Justin. "A Phenomenological Study on Teacher Perception of Change in School Culture as a Result of the Implementation of Mindfulness." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3366.
Анотація:
A qualitative investigation was conducted to explore the phenomenon of teacher perception of change in school culture as a result of the implementation of mindfulness. This study used a phenomenological methodology, enabling the researcher to gather information by focusing on and describing the impact of mindfulness on school culture in a deep comprehensive manner.
The investigator was able to extract meaning and code data, leading to the emergence of themes that supported and aligned with the study’s research questions and thus led into a holistic understanding of the phenomenon. This was accomplished through data analysis of rich, in-depth interviews, onsite visits, and document analysis, which consisted of aggregate student disciplinary information, aggregate achievement results, the state report card, attendance records, teacher retention records, and faculty survey results. The quality of data sources led to saturation, and variety of sources allowed for triangulation of the results.
The principal researcher in this study found that mindfulness results in a large, positive impact on school culture, including improved relationships among stakeholders, improved academic performance, and a decrease in disciplinary incidents. This was evidenced and supported by a thorough literature review, the results of participant interviews, and document analysis. The researcher also specified factors teachers perceived as essential to the implementation of mindfulness in schools and provided practical suggestions for putting mindfulness in place as well as suggestions for future research. The results from this study provide a framework for understanding and exploring the phenomenon.
28
Hajduk, Alexandra M. "Cognitive Status and Initiation of Lifestyle Changes Following Acute Coronary Heart Syndrome: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/701.
Анотація:
Background: Cognitive impairment is prevalent in survivors of acute coronary syndrome (ACS) and increases risk for poor outcomes. Lifestyle changes are recommended to patients after ACS to reduce their risk for recurrent events, but cognitively impaired patients may encounter difficulties initiating these changes. This dissertation had three aims: (1) to examine cognitive status as a predictor of lifestyle changes after ACS, (2) to examine whether caregiver support moderates the association of cognitive status and initiation of lifestyle changes, and (3) to assess the reliability of self-reported lifestyle changes in cognitively impaired patients through comparison of their reports of lifestyle change with those from their caregivers.
Methods: For aims 1 and 2, Poisson regression with robust error variance was used to examine the association of cognitive status and caregiver support with patient-reported initiation of five lifestyle changes (improving diet, increasing exercise, quitting smoking, reducing stress, and attending cardiac rehabilitation) in 881 patients from TRACE-CORE, a prospective longitudinal observational study of outcomes in ACS. For aim 3, pilot data from 78 patient-caregiver dyads from TRACE-CARE, an ancillary substudy, were used to examine whether patient-caregiver congruence on reports of lifestyle changes varied according to patients’ cognitive function.
Results: Patient-reported rates of lifestyle change did not vary according to cognitive status, except for participation in cardiac rehabilitation. Caregiver support improved patient-reported rates of lifestyle change among cognitively intact patients but not cognitively impaired patients. Patients’ cognitive function was positively associated with patient-caregiver congruence on reports of initiation of lifestyle changes and patients with decreased cognitive function tended to over-report initiation of lifestyle changes compared to reports by their caregivers.
Conclusion: Although cognitive status was not associated with initiation of most lifestyle changes and the influence of caregiver support on initiation of lifestyle changes was only beneficial to cognitively intact patients in this cohort of ACS patients, these null findings may be explained by the questionable validity of self-report in cognitively impaired patients. This dissertation yields new knowledge about secondary prevention in ACS patients and provides insight into the challenges of conducting patient-reported outcomes research in cognitively compromised populations.
29
Hajduk, Alexandra M. "Cognitive Status and Initiation of Lifestyle Changes Following Acute Coronary Heart Syndrome: A Dissertation." eScholarship@UMMS, 2003. http://escholarship.umassmed.edu/gsbs_diss/701.
Анотація:
Background: Cognitive impairment is prevalent in survivors of acute coronary syndrome (ACS) and increases risk for poor outcomes. Lifestyle changes are recommended to patients after ACS to reduce their risk for recurrent events, but cognitively impaired patients may encounter difficulties initiating these changes. This dissertation had three aims: (1) to examine cognitive status as a predictor of lifestyle changes after ACS, (2) to examine whether caregiver support moderates the association of cognitive status and initiation of lifestyle changes, and (3) to assess the reliability of self-reported lifestyle changes in cognitively impaired patients through comparison of their reports of lifestyle change with those from their caregivers.
Methods: For aims 1 and 2, Poisson regression with robust error variance was used to examine the association of cognitive status and caregiver support with patient-reported initiation of five lifestyle changes (improving diet, increasing exercise, quitting smoking, reducing stress, and attending cardiac rehabilitation) in 881 patients from TRACE-CORE, a prospective longitudinal observational study of outcomes in ACS. For aim 3, pilot data from 78 patient-caregiver dyads from TRACE-CARE, an ancillary substudy, were used to examine whether patient-caregiver congruence on reports of lifestyle changes varied according to patients’ cognitive function.
Results: Patient-reported rates of lifestyle change did not vary according to cognitive status, except for participation in cardiac rehabilitation. Caregiver support improved patient-reported rates of lifestyle change among cognitively intact patients but not cognitively impaired patients. Patients’ cognitive function was positively associated with patient-caregiver congruence on reports of initiation of lifestyle changes and patients with decreased cognitive function tended to over-report initiation of lifestyle changes compared to reports by their caregivers.
Conclusion: Although cognitive status was not associated with initiation of most lifestyle changes and the influence of caregiver support on initiation of lifestyle changes was only beneficial to cognitively intact patients in this cohort of ACS patients, these null findings may be explained by the questionable validity of self-report in cognitively impaired patients. This dissertation yields new knowledge about secondary prevention in ACS patients and provides insight into the challenges of conducting patient-reported outcomes research in cognitively compromised populations.
30
Di, Meglio Antonio. "Health Behaviors and Breast Cancer Survivorship Body Weight and Return to Work Among Survivors of Early-Stage Breast Cancer. Changes in Weight, Physical and Psychosocial Patient-Reported Outcomes Among Obese Women Receiving Treatment for Early-Stage Breast Cancer: A Nationwide Clinical Study." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASL059.
Анотація:
Les survivantes du cancer du sein (CS) de stade précoce ont souvent un impact considérable et persistant des symptômes liées aux traitements. Cette thèse rassemble plusieurs projets exploitant les données de l'étude CANcer TOxicity (CANTO; NCT01993498) pour comprendre le potentiel des comportements de santé (CSAN), notamment le maintien d'un indice de masse corporelle (IMC) sain, le respect des recommandations en matière d'activité physique (AP), l'arrêt du tabac et la limitation de la consommation d'alcool, pour préserver la qualité de vie (QV) chez les survivantes du CS. CANTO est une cohorte multicentrique et prospective de CS de stade I-II-III. La cohorte recueille des informations clinico-comportementales (IMC, consommation de tabac et d'alcool, AP [GPAQ-16]), psychologiques (HADS), sociodémographiques, et liées au traitement. Les toxicités sont évaluées par les « patient-reported outcomes (PROs)» (EORTC QLQ-C30, -BR23 et -FA12) et par CTCAE. Les patientes font l'objet d'un suivi longitudinal annuel à compter du moment du diagnostic. Un certain nombre de méthodes statistiques ont été utilisées pour l'analyse des données, notamment la régression linéaire et logistique multivariable, la régression multinomiale, les modèles mixtes à effets aléatoires et les analyses de classe latente. Dans une première partie, cette thèse vise à (1) décrire les CSAN dans l’après CS, en se concentrant sur les facteurs de risque (FR) de persistance des comportements malsains. Ensuite, ce travail vise (2) à caractériser les toxicités et à définir leur interaction avec les CSAN. Des groupes de patientes à a priori risque élevé des toxicités ont été évalués : (2a) les patientes recevant une chimiothérapie (CT) adjuvante, afin de décrire la QV et sa relation avec les CSAN, et (2b) les patientes obèses, afin d'explorer l’association des PROs avec les changements de poids, l’impact social du CS et sa relation avec l’IMC. Les principales conclusions sont les suivantes : (1) certaines femmes ont amélioré leur CSAN après CS, bien que la plupart des comportements malsains de base aient persisté, avec des déterminants cliniques, sociodémographiques et psychologiques fluctuant selon le CSAN ; (2a) il y a une grande variabilité dans les trajectoires de la QV après la CT, un groupe de patientes ayant une forte détérioration des PROs, et étant également particulièrement enclin à des comportements malsains ; (2b) parmi les patientes obèses, la perte de poids était associée à de meilleurs PROs après traitement et à des taux plus élevés de retour au travail. Dans une deuxième partie, cette thèse a exploré une étude de cas spécifique, en se concentrant sur la fatigue liée au cancer (FAT). Dans un premier temps, (3) la prévalence et les FR de la FAT sévère (globale, physique, émotionnelle et cognitive) ont été évalués. Nous avons ensuite (4) caractérisé la mise en œuvre des stratégies de gestion recommandées pour améliorer la FAT, y compris l’AP. Les résultats ont révélé que : (3) il existe une forte prévalence et persistance de la FAT sévère après CS, avec une multitude de FR comprenant la détresse psychologique, les symptômes concomitants et les comportements malsains, en particulier surpoids et tabagisme (des équations prédictives préliminaires ont également été générées) ; et que (4) l'application des recommandations pour améliorer la FAT, ainsi qu’en matière d’AP, semblait sous-optimale. L'objectif principal de cette thèse était d'éclairer les interventions comportementales ciblées pour les patientes à risque de toxicité persistante. Ce travail a abouti (5) à la génération d'un protocole d'étude pour un essai randomisé de phase III : « Motivating to Exercise and Diet, and Educating to healthy behaviors After breast cancer - MEDEA ». Cette étude, visant à évaluer l'impact d'une intervention personnalisée de perte de poids sur la FAT chez les survivantes de CS en surpoids et obèses, est actuellement en cours (NCT04304924)Survivors of early-stage breast cancer (BC) often face relevant late and long-term health-related sequelae, downstream functional impact of treatments and persistent symptoms. This thesis gathers several projects exploiting data of the CANcer TOxicity study (CANTO; NCT01993498), to understand the potential of health behaviors (HB), including maintenance of a healthy body mass index (BMI), adherence to physical activity (PA) recommendations, tobacco abstinence and limitation of alcohol consumption, to improve overall health and preserve quality of life (QOL) of BC survivors. CANTO is a nationwide, prospective cohort of patients with stage I-II-III BC. Longitudinal clinico-behavioral (e.g., nurse-reported BMI, tobacco and alcohol use, PA [GPAQ-16]), psychological (HADS), socio-demographic, and treatment data are available at diagnosis and yearly afterwards. Treatment-related toxicities are extensively assessed by patient-reported outcomes (PROs; EORTC QLQ-C30, -BR23, and -FA12) and by provider’s evaluation (CTCAE). A number of statistical analytic methods were involved in this thesis, including multivariable linear and logistic regression, multinomial regression, random-effects mixed-models, and latent-class analyses (i.e., group-based trajectory models). In the first part, this thesis aimed at (1) describing HB over the survivorship period, focusing on risk factors for persistent unhealthy behaviors, and at (2) characterizing the evolution of treatment-related toxicities and defining their interplay with HB. We assessed QOL in two specific and frail populations, at risk of severe downstream treatment impact: (2a) among patients receiving adjuvant chemotherapy (CT) and (2b) among obese BC survivors, where we also specifically studied the social impact of BC and its relationship with BMI. Key findings included the following: (1) most women pursue a healthy lifestyle and some are prone to improvements after diagnosis, although unhealthy behaviors tend to persist, with varying clinico-demographic and psychological determinants by HB; (2a) there is great variability in trajectories of post-CT QOL, with a clinically relevant cluster of patients reporting severely deteriorating QOL, never recovering to pre-treatment levels for over 4 years, and being also particularly prone to unhealthy behaviors; (2b) among obese survivors, those that lose weight report less of a decline in PROs, without evidence of worsened functionality or symptomatology in any QOL domain. Moreover, excess weight seems to represent a barrier to occupational reintegration, and weight loss is associated with higher rates of return-to-work after BC. In its second part, the thesis explored a core case-study, cancer-related fatigue (CRF). First, (3) prevalence and risk factors for severe CRF were evaluated, analyzing global CRF and its physical, emotional, and cognitive dimensions. We then (4) characterized the uptake of recommended management strategies to improve CRF, including PA. Findings revealed that: (3) there is a high prevalence of post-treatment severe CRF, which stays persistently elevated over time, with a multitude of risk factors including psychological distress, concomitant symptoms, and unhealthy behaviors, particularly excess weight and tobacco use (preliminary predictive equations were generated); (4) recommendations uptake, including PA adherence, seems suboptimal and in need of implementation in clinical practice. The overarching goal of this thesis was to inform targeted behavioral interventions for patients at risk of persistent toxicities. This work resulted therefore in (5) the generation of a study protocol for a phase III randomized trial: “Motivating to Exercise and Diet, and Educating to healthy behaviors After breast cancer - MEDEA”. This study, aimed to evaluate the impact of a personalized telephone-based weight loss intervention on CRF in overweight and obese BC survivors, is currently ongoing (NCT04304924)
31
Haile, Yohannes. "Sustainable Value And Eco-Communal Management: Systemic Measures For The Outcome Of Renewable Energy Businesses In Developing, Emerging, And Developed Economies." Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1459369970.
32
(9790934), Cally Jennings. "Internet delivered physical activity interventions for primary and secondary prevention: Increasing website usage and improving behaviour change outcomes." Thesis, 2011. https://figshare.com/articles/thesis/Internet_delivered_physical_activity_interventions_for_primary_and_secondary_prevention_Increasing_website_usage_and_improving_behaviour_change_outcomes/13459277.
Анотація:
"Research highlights the increasing burden of physical inactivity and chronic disease ... The overall purpose of this research was to explore the utility and effectiveness of internet delivered physical activity behaviour change programs in primary and secondary prevention ... The second step was to examine predictors of website usage within a current publicly accessible physical activity website (10,000 Steps) aimed at primary prevention "--Abstract.
33
Swain, Jessica. "A randomised controlled trial of acceptance and commitment therapy for anxious adolescents: effectiveness and mechanisms for change." Thesis, 2015. http://hdl.handle.net/1959.13/1312693.
Анотація:
Research Doctorate - Doctor of Philosophy (PhD)Anxiety disorders affect approximately 10-30% of children and adolescents. While traditional Cognitive Behaviour Therapy (CBT) is the first-line psychosocial treatment for children with anxiety, a significant proportion are nonresponsive or exhibit residual symptomatology at treatment cessation. Acceptance and Commitment Therapy (ACT) has been found to be effective among adults with anxiety disorders and children with other psychiatric conditions. ACT fosters psychological flexibility via putative mediators of change that form a “hexaflex” model: acceptance, defusion, mindfulness, self-as-context, committed action and valued living. This research examined ACT versus CBT in the treatment of anxiety disorders among children and adolescents. Among adolescents, an exploratory investigation of ACT mediators for change was undertaken. One-hundred-and-ninety-three children were block randomised to a manualised 10-week group format ACT or CBT program, or to waitlist control (WLC). Repeated clinical – clinician/self/parent-reported anxiety, depression and problem behaviours – and quality of life (QOL) measures – anxiety interference, psychosocial and physical health-related QOL – were taken pretreatment, posttreatment and 3-month follow-up (3MFU). Completers were 157 children, 58% female, with a mean age of 11 years (SD = 2.8). Completer and intention-to-treat (ITT) analyses revealed ACT and CBT were both superior to WLC across outcomes, reflecting statistically and clinically significant differences, with gains maintained at 3MFU. While WLC improved significantly on some outcomes at posttreatment, improvements were not clinically significant. Both completer and ITT analyses found ACT and CBT to produce similar outcomes. However, on ITT 3MFU results, CBT evidenced significantly lower scores on clinician-, but not self- or parent-reported outcomes. Mediation results were mixed. The hexaflex mediated the relationship between treatment and clinician-rated anxiety severity for ACT only; with treatment common effects observed for depression and self-reported anxiety. Acceptance and defusion emerged as specific mediators and evidenced the same pattern of effects, with clinician-rated anxiety effects treatment common. Hexaflex effects were accounted for by acceptance and defusion, as all other process measures were nonsignificant. Mediation analyses for parent-rated and QOL outcomes were nonsignificant. Few changes in process measures were observed post to 3MFU and mediation effects were nonsignificant. In conclusion, ACT and CBT are both effective in improving clinical and QOL outcomes among children with anxiety. Despite mixed results, there was some evidence for acceptance and defusion as treatment common change mediators. Limited support was obtained for the hexaflex model, the processes of valued action and mindfulness/self-as-context and the treatment specificity of mediation effects. ACT may be a viable alternative evidence based treatment option for clinicians working with children with anxiety disorders. Despite their differences ACT and CBT may be underpinned by analogous mechanisms.
34
Harkin, Katherine. "Motivational interviewing in female breast cancer survivors and its influence on step count and quality of life: a randomised crossover pilot study." Thesis, 2022. https://vuir.vu.edu.au/44682/.
Анотація:
Up to 70% of female breast cancer survivors (fBCS) fail to achieve recommended physical
activity (PA) levels due to unique geographical, financial, emotional, aspirational and
physical barriers that commonly as a result of diagnosis and treatment. This is problematic as
it can lead to a poor health prognosis long-term. Therefore, research into motivational
strategies to improve adherence to PA is pivotal. However, studies commonly incorporate
complex interventions that are not always feasible nor founded in established behavioural
change theories. The overall aim of this cross-over randomised pilot study was to investigate
the effect of a psychological tool, motivational interviewing (MI), on levels of self-directed
PA (as measured by step count), quality of life (QoL), self-efficacy and self-regulatory types.
The behavioural change theory used to inform the design of the intervention, the selfdetermination theory (SDT), focuses on enhancing an individual’s intrinsic motivators to
change and developing a strong sense of autonomy over their behaviour. This pilot study is a
component of a larger trial that will investigate the outcomes mentioned before in addition to
immune function and psychological health. The results of this pilot study showed there was
no effect of MI on any of the outcomes except for the breast cancer subscale within the QoL
measure. There is great variation in these findings in comparison to other research, however,
understanding the sources of the large heterogeneity found between studies is vital to finding
the key moderators and help to inform future research. Limitations included the global
COVID19 pandemic which impacted recruitment, health status and ability of the participants
to engage in self-directed PA as well as the small sample size which means results should be
interpreted with caution. Additional limitations were possible under-reporting of step count
data from the FitBit monitor. Suggestions for future research are inclusion of other tools such
as tailored print materials, additional self-reporting PA measures, a change of QoL measure,
online support and group walking sessions. Additionally, increasing the number of MI
sessions including an initial in-person session as well as other objective measures to ensure
the fidelity of the MI. Finally, incorporating another behavioural framework to enhance social
aspects of the self-directed PA components and intentional aspects of the intervention to
facilitate greater changes as well as a two-armed RCT design rather than cross-over is
recommended. This study has been invaluable in identifying key aspects of MI and study
design to help inform future research that may produce evidence to ultimately improve the
well-being of fBCS long-term.
35
(9787793), Natalie Clohesy. "Patient reported outcome measures (PROM) in chiropractic practice in Australia: Can targeted education designed to enhance knowledge and understanding, promote clinical behaviour change and result in increased PROM utilisation." Thesis, 2023. https://figshare.com/articles/thesis/Patient_reported_outcome_measures_PROM_in_chiropractic_practice_in_Australia_Can_targeted_education_designed_to_enhance_knowledge_and_understanding_promote_clinical_behaviour_change_and_result_in_increased_PROM_utilisation/24589224.
Анотація:
Patient reported outcome measures (PROMs) are commonly utilised in clinical practice within healthcare and are considered an effective tool for communication between clinician and patient. Patient reported outcome measures are defined as any report of the status of a patient’s health condition that comes directly from the patient.
The aims of this research project were: (i) to identify the most commonly cited PROMs for low back pain (LBP) within the chiropractic literature; (ii) to establish the current utilisation of PROMs for LBP amongst chiropractors in Australia and to identify the potential barriers and facilitators for use; (iii) to evaluate factors that are associated with utilisation of PROMs in chiropractic practice; and (iv) using the New World Kirkpatrick Model (NWKM), to determine whether an education package intervention increases chiropractors’ knowledge, modifies attitudes and beliefs and creates clinical behaviour change (v) to determine whether knowledge to action (KTA) was an appropriate framework for educating the chiropractic profession regarding PROMs.
A systematic narrative review was conducted to determine the most commonly cited PROMs for LBP within the chiropractic literature. The review identified 144 articles and 75 different PROMs. The four most cited PROMs were the Oswestry Disability Index, Numeric Rating Scale, Visual Analogue Scale and Roland Morris Questionnaire. The cohort surveys determined the current utilisation of PROMs for LBP amongst chiropractors in Australia, identified barriers and facilitators for clinical use, and reported chiropractors’ knowledge, understanding, beliefs and utilisation of PROMs. Cohort survey 1 included 558 participants and found that the LBP PROM utilisation rate in clinical practice was 72.5%. The second cohort survey, consisted of three online surveys (2a, 2b and 2c) and the delivery of an educational package intervention. The education intervention was evaluated using the NWKM. This model established that the reaction to the education package was very positive with a mean response scores (1–5 Likert scale) for the reaction questions ranged from 3.75 to 4.43. There was a small, but significant, increase in knowledge (score out of 32) at four weeks (27.2 ± 5.5) and 12 weeks after receiving the education package (27.4 ± 5.1), when compared to baseline scores (24.2 ± 6.1). Additionally, there was a small and significant (p<0.05) increase in utilisation of health-related PROMs 12 weeks after the intervention. While there was a small improvement in PROM knowledge, the utilisation of other PROMs did not change. The survey revealed that the main barriers to PROM use were a lack of understanding/knowledge of PROMs, which PROMs to use, how to use them and the perception of PROMs being time consuming to apply and score. The predictive factor which increased PROM utilisation in chiropractic practices was their use by principal chiropractors (Wald = 4.101, p = 0.04, OR = 1.4 (1.0–2.1)) compared to associate chiropractors. Other demographic factors and the perceived value clinicians placed on PROMs were not associated with the frequency of usage. The research suggested the KTA framework was a useful guide to translating knowledge of PROMs into clinical practice.
This research is considered important and resulted in multiple original contributions to knowledge in the field of PROMs. Creating a unique list of the most frequently cited PROMs for LBP in the chiropractic literature provides information which had not previously been established. The longitudinal surveys established the most commonly utilised PROMs for LBP, the current knowledge, beliefs and attitudes regarding PROMs and barriers and facilitators to their clinical use. An additional finding determined that being a principal chiropractor was associated with an increase in the utilisation of PROMs. The education package intervention was well received by the target audience and improved PROM knowledge amongst the participants. Finally, the KTA framework was useful to identify gaps in PROM literature and clinicians’ knowledge and uncovering operational issues when translating research into clinical practice. These factors had not previously been investigated within the chiropractic profession of Australia and therefore add unique value to the chiropractic research space.
36
"An Exploration of Changes in Healthcare Providers' Learning Outcomes Related to Breastfeeding Support and Promotion." Doctoral diss., 2015. http://hdl.handle.net/2286/R.I.35985.
Анотація:
abstract: Despite the widely recognized health benefits of breastfeeding and its endorsement by leading health organizations, as a preventative public health intervention, inadequate breastfeeding knowledge and lactation management skills among healthcare providers continues to be a major barrier for women who choose to initiate breastfeeding. Breastfeeding competencies are not standardized in healthcare education for any of the health professions. To address this gap, a few continuing education and professional development programs have been implemented, but paucity in research regarding the efficacy of these programs exists. The purpose of this study was to explore the changes in healthcare providers’ learning outcomes related to breastfeeding support and promotion.
A non-experimental pre-posttest self-report survey design was used to assess the feasibility and preliminary efficacy of an online breastfeeding educational intervention for healthcare providers. The Theory of Planned Behavior (TPB) provided the framework for exploring the participants’ psychological and behavioral outcomes. The research questions were: (1) What is the feasibility of an online breastfeeding course for healthcare providers? (2) What are healthcare providers’ psychological and behavioral changes occurring after completion of an online course? (3) How do the post-intervention psychological and behavioral outcomes of the online format compare with those of the previous format (hybrid) of this breastfeeding course?
Although participants’ favorably assessed the feasibility (i.e., acceptability) of the 45-hour course, several factors contributed to participants’ satisfaction level: Previous online learning experience, connectedness with others, and the degree of structural support. Significant positive changes occurring in participants were increases in their knowledge and beliefs about breastfeeding; attitudes toward formula feeding; perceived behavioral control; perceptions about being able to perform breastfeeding supportive behaviors; and intentions to perform actions that are consistent with evidence-based breastfeeding supportive behaviors. Significant changes in the beliefs about formula feeding were not in the expected direction raising conceptual and pedagogical issues. Participants had negative perceptions about being able to implement what they learned in their workplaces or to affect policy. Findings support the use of online breastfeeding education programs for healthcare providers; changes at both individual and institutional levels are necessary to change provider practices.Dissertation/Thesis
Doctoral Dissertation Nursing and Healthcare Innovation 2015
37
Liao, Shu Fen, and 廖淑芬. "The Relationship between Stages of Behavior Change and Care Outcome in diabetes: The Moderating Role of Health Literacy." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/32942995556010196744.
Анотація:
碩士長庚大學
管理學院碩士學位學程在職專班醫務管理組
100
Diabetes is a chronic disease and one of Taiwan’s top ten causes of death. It not only threatens patients’ lives but also increases national health expenditures. How to improve diabetes health outcome becomes an important topic in health care management. More recently, studies show that health literacy is an important factor for chronic diseases management. This research aims to investigate the health literacy as a factor moderating the relationship between stages of behavior change and health outcome among people with type 2 diabetes. The results of this study will provide valuable suggestions to health care providers and government departments. In this cross-sectional survey study, a total of 232 patients with type 2 diabetes were recruited from Endocrinology & Metabolism or Family Medicine clinics of a District Hospital in northern Taiwan. Participants completed questionnaires in outpatient service while their hemoglobin (HbA1c) data were retrieved from medical records. Questionnaires used in this study included basic personal data, the Stages of Dietary Change Scale, and The Newest Vital Sign (NVS) for health literacy. The results show that health literacy is significantly associated with Patients’ age and education (p<0.001). On the basis of the moderating-mediating analysis, we found that health literacy is a significant moderator of the relationship between the stages of behavior change and the HbA1c level by controlling demographic and medicine-related variables. These results suggested that patients with more adequate health literacy understand their condition and make effective control of their diseases, which in turn increases their intention of diet control. On the contrary, those with inadequate health literacy are more likely to have poor diabetes control outcome even they have intentions to change their dietary behaviors due to lack of necessary knowledge or skills. As health literacy plays important role for diabetes healthcare outcome, healthcare providers may screen the patients’ health literacy level in clinics, and such information will help to design appropriate health education for individual patients, which in turn will improve patients’ health behavior to enhance their diet control.
38
Liang, Ko-Ning, and 梁格寧. "The Outcome Evaluation of Climate Change Curriculum to Improve Senior High School Students’ Environmental Hope and Environmental Behaviors." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/2g4575.
39
Lim, Kah Aeng Clarise. "Working out with F.I.D.O. (Frequency, Intensity, Duration, & Outcomes) - a feasibility randomized controlled trial." Thesis, 2017. https://dspace.library.uvic.ca//handle/1828/8431.
Анотація:
Objective: Dog owners have been shown to walk more per week compared to non-dog owners; however, 60% of dog owners are still not walking their dogs at intensities sufficient to reap optimal health benefits. The aim of this study was to evaluate the feasibility, acceptability, and efficacy of a 9-week feasibility randomized controlled trial involving a program of six weekly scheduled instructor-led group dog walks supplemented with theory-based strategies to encourage increased dog walking among dog owners in Greater Victoria, BC. Methods: This study was based on the multi-process action control (M-PAC) framework and utilized an open parallel randomized controlled trial design involving experimental and waitlist-control group participants. Quantitative data was collected using pedometers and self-report measures. A program evaluation survey was administered upon the completion of the study. Primary outcomes examined the feasibility and acceptability of the program; secondary outcomes analyzed pedometry and self-report moderate-to-vigorous physical activity (MVPA) data; and tertiary outcomes observed changes in participants’ perceptions of M-PAC constructs. Percentage calculations were used to obtain primary outcomes, and analysis of covariance (ANCOVA; controlling for baseline) was performed to examine secondary and tertiary outcomes to explore the direction of effects and obtain a first estimate of expected effect sizes. Eligibility: Male and female adults aged 18+ living in Greater Victoria, BC, who owned at least one healthy and friendly dog aged six months and above, who were not meeting recommended guidelines of 150 minutes of MVPA per week, and who were medically cleared to participate. Results: Feasibility outcomes included 74 interested responses, 23% recruitment rate (n = 17), 94% retention rate (n = 16), and 94% adherence rate (n = 15). Program participants were overall (very) satisfied with the program – worksheets (62.5%), program instructor (100%), various program/group dog walks logistics (75% to 100%). Total weekly step counts and average daily step counts, MVPA dog walking, and MVPA with dog increased at the end of the program and at follow-up, resulting in large effect sizes when compared to the waitlist-control group. MVPA dog walking and total MVPA (with and without dog) exceeded recommended guidelines at follow-up. Positive changes across time were observed for dog responsibility and M-PAC constructs of affective judgments, opportunity, planning, identity, and habit, resulting in medium and large effect sizes when compared to the waitlist-control group. Conclusions: This six-week group dog walking program is overall feasible, acceptable, and efficacious in encouraging increased dog walking and MVPA among dog owners. Attendance at weekly scheduled instructor-led group dog walks and exposure to the M-PAC construct worksheets resulted in program participants’ adoption and maintenance of positive behavioral changes at the end of the program and at follow- up. Program participants reported enjoying the program and being (very) satisfied with it. It is recommended for future studies to refine/modify initial recruitment strategies and eligibility criteria, reimburse medical/veterinarian clearance costs to reduce cost-related barriers to participation, offer a variety of options for program delivery (e.g., different locations/schedules/seasons, online programs, multi-site study) to accommodate more participants, and apply the M-PAC framework to a larger sample.Graduate
40
Santiago, Leoni Esplin. "An exploration of the effects of karate training on young children in Kwanonqaba, Mossel Bay." Diss., 2020. http://hdl.handle.net/10500/27172.
Анотація:
Constant exposure to community violence has very detrimental and pervasive effects on children. These effects range from behavioural, cognitive and neuro-developmental problems to a variety of psychiatric disorders. The purpose of this study was to investigate whether
Karate programs can be used in violent communities to help children circumvent these detrimental effects of exposure to violence. This study adopted a qualitative research approach and the epistemological framework used was social constructivism. Group interviews were conducted with the research participants. The case study method was
chosen, and thematic analysis was used as the method of analysis of the children’s stories.
These stories were reconstructed in terms of themes. The themes that emerged included: anxiety, fear, discipline, respect for self, others and authority. After exposure to a traditional karate program for a period of time, the participants’ attitudes towards violence changed.
They believed that violence was a last resort and that there were better ways to deal with conflict. They began developing more self-discipline, not just in the dojo but in other areas of their lives as well. The participants learnt to respect others, as well as themselves and their
instructors, teachers, parents and friends. They also felt less afraid to be in their community and developed more self-confidence. Karate programmes can be used in violent communities to help prevent the negative outcomes in children associated with exposure to violence.
These programmes can be used in conjunction with other developmental programmes to help improve the outcomes of these children.Psychology
M.A. (Psychology)
41
Carstens, Christoffel. "Invloed van televisie op die verwestersingsproses by die Swart adolessent." Thesis, 1995. http://hdl.handle.net/10500/16335.