Дисертації з теми "People living with a Long-Term Conditions"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: People living with a Long-Term Conditions.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-42 дисертацій для дослідження на тему "People living with a Long-Term Conditions".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте дисертації для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Brassington, Linsay. "Better living with illness : transdiagnostic approaches to psychological interventions for people with chronic illness." Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/20955.
Анотація:
Objective: Chronic physical health problems are on the rise. Psychological interventions can play a role in helping people cope with the challenges that long term physical conditions brings. This thesis systematically reviewed the literature for group psychological interventions. Following this, an Acceptance and Commitment Therapy group intervention for people living with a range of long term physical conditions was designed and evaluated. Methods: Key databases were searched for relevant randomized-controlled studies. Papers that met inclusion criteria were quality assessed, and a meta-analysis was conducted. Participants with chronic physical health conditions were invited to an Acceptance and Commitment Therapy group (n=53). Measures were completed at assessment, pre, post and 3-month follow-up. These assessed anxiety and depression symptoms, health perceptions, values-based living and psychological flexibility. Assessment to pre-intervention served as a within-participant control. Results: 22 relevant studies were retrieved, with 18 rated as acceptable or high quality and 14 included in a meta-analysis. The majority of studies reported interventions as efficacious at reducing mental health problems, though effect sizes were weaker when compared to active controls such as education. In the Acceptance and Commitment therapy group, depression and anxiety symptoms reduced significantly from pre to post, compared to control period. Conclusions: Group psychological interventions may be beneficial for people with physical health problems. In particular, group-based ACT interventions may be effective with this population and can be delivered transdiagnostically for a range of physical conditions.
2
Moncorps, Florence. "Pratiques réflexives des personnes vivant avec une maladie chronique : étude compréhensive mobilisant une méthodologie mixte." Electronic Thesis or Diss., Paris 10, 2023. http://www.theses.fr/2023PA100140.
Анотація:
Cette thèse s’intéresse aux circonstances et processus d’élaboration des savoirs expérientiels des personnes vivant avec une maladie chronique. Elle concerne spécifiquement des situations informelles d’élaboration de ces savoirs, plus pertinentes en termes d’analyse du pouvoir d’agir des personnes concernées.Cette contribution cherche à identifier les pratiques réflexives de ces personnes et à comprendre comment leur environnement et leurs dispositions individuelles les influencent. Pour cela, les cadres théoriques de l’agentivité (Bandura, 1986) et de la réflexivité (Dewey, 1910, 1938 ; Schön, 1983 ; Kolb, 1974) sont croisés. Ce croisement conduit à l’élaboration d’un modèle embryonnaire des pratiques réflexives. Le modèle de la réciprocité causale triadique (Bandura, 1986) est utilisé pour identifier les variables environnementales et dispositionnelles à étudier. Pour éprouver ce modèle embryonnaire, la première investigation empirique consiste en sept entretiens non directifs, auprès de personnes vivant avec différentes maladies chroniques. La deuxième s’appuie sur un questionnaire, co produit en partie avec des personnes concernées et associées par ailleurs plus largement à la thèse, via des Focus Group. Il est diffusé en ligne auprès de personnes concernées. À partir des 1404 réponses complètes collectées, des analyses en composantes principales permettent de décrire les relations entre les pratiques réflexives des répondants, leurs buts et supports d’information. Elles sont complétées par des ellipses de confiance et tests de Man Whitney Wilcoxon. Les répondants sont principalement des femmes, de plus de 35 ans, avec un niveau d'éducation supérieur au baccalauréat. La plupart sont atteints d'une encéphalomyélite myalgique et/ou d’un syndrome de fatigue chronique pouvant entraîner une incapacité à travailler. Ils souffrent de leur maladie depuis longtemps et se sentent peu reconnus socialement. Ils adoptent plutôt une attitude d’apprenance face aux savoirs médicaux. Ils vivent avec des maladies non reconnues par le système de santé, ayant une faible prévalence et un faible niveau de technicisation. Après analyse, deux systèmes de processus réflexifs cohabitent pour résoudre les écarts par rapport à l’auto-normativité (Andrieu, 2012 ; Barrier, 2008 ; Baeza, 2020) des personnes vivant avec une maladie chronique. Nos méthodes de recueil ont principalement permis de le mettre à jour et de décrire des processus analytiques longs (Dewey, 1910, 1938 ; Schön, 1983 ; Kolb, 1974).Au-delà des pratiques imaginées dans le modèle embryonnaire, l’analyse montre la mobilisation d’une pratique individuelle de défense réflexive. Concernant les processus cognitifs, les personnes construisent un environnement personnel de recherche ou réflexivité à partir de leurs perceptions et/ou ressentis, de supports d’informations (associations de malades, blogs), de professionnels en lien avec la santé et de profanes (proches, famille ou collègues). Leur environnement et dispositions influencent leurs pratiques de façons différentes au regard des modalités de variables explorées. Enfin, six motifs d’engagement en réflexivité, en référence aux motifs d’engagement en formation de Carré (1998), sont identifiés : épistémique, socio-affectif, économique, opératoire personnel, identitaire et vocationnel. Trois buts distincts sont repérés quant à la mobilisation de pratiques chez les personnes interrogées : maintenir son insertion sociale, gérer la maladie et maintenir les relations avec ses proches. La discussion porte sur la proximité entre pratiques réflexives des personnes vivant avec une maladie chronique et raisonnement clinique tel qu’il est enseigné aux professionnels de santé. Ceci incite à plus de coopération réflexive entre professionnels de santé et personnes concernées pour répondre aux problèmes quotidiens en lien avec la maladie chroniqueThis Phd thesis focuses on the circumstances and processes involved in the elaboration of experiential knowledge by people living with chronic illness. It specifically concerns informal situations in which this knowledge is developed, which are more relevant in terms of analyzing the power to act of the people concerned.This contribution seeks to identify the reflexive practices of these people and to understand how their environment and individual dispositions influence them. To this end, the theoretical frameworks of agency (Bandura, 1986) and reflexivity (Dewey, 1910, 1938; Schön, 1983; Kolb, 1974) are crossed. This intersection leads to the development of an embryonic model of reflexive practices. The triadic causal reciprocity model (Bandura, 1986) is used to identify the environmental and dispositional variables to be studied.To test this embryonic model, a first empirical investigation consisted of seven non-directive interviews with people living with various chronic illnesses. A second is based on a questionnaire, co-produced in part with the people concerned and more widely associated with the thesis, via Focus Groups. It is distributed online to the people concerned.Based on the 1,404 complete responses collected, principal component analyses are used to describe the relationships between respondents' reflexive practices, their information goals and media. They are completed by confidence ellipses and Man Whitney Wilcoxon tests.Respondents are mainly women, over 35 years of age, with a level of education higher than the baccalaureate. Most suffer from myalgic encephalomyelitis and/or chronic fatigue syndrome, which can lead to an inability to work. They have been suffering from their illness for a long time, and feel little social recognition. They tend to adopt a learning attitude towards medical knowledge. They live with illnesses that are not recognized by the healthcare system, have a low prevalence and a low level of technicalization.After analysis, two processes coexist to resolve the deviations from self-normativity (Andrieu, 2012; Barrier, 2008; Baeza, 2020) of people living with a chronic illness. Our collection methods have mainly uncovered and described lengthy analytical processes (Dewey, 1910, 1938; Schön, 1983; Kolb, 1974).Beyond the practices imagined in the embryonic model, the analysis shows the mobilization of an individual practice of reflexive defense. As far as cognitive processes are concerned, people construct a personal environment of research or reflexivity based on their perceptions and/or feelings, information supports (patients' associations, blogs), health-related professionals and laypeople (close friends, family or colleagues). Their environment and dispositions influence their practices in different ways, depending on the variables explored. Finally, six motives for engagement in reflexivity, in reference to Carré's (1998) motives for engagement in training, are identified: epistemic, socio-affective, economic, personal operative, identity and vocational. Three distinct goals are identified for the mobilization of practices among the people interviewed: maintaining social integration, managing illness and maintaining relationships with relatives.The discussion focuses on the proximity between the reflexive practices of people living with chronic illness and clinical reasoning as taught to healthcare professionals. This encourages greater reflexive cooperation between healthcare professionals and the people concerned, in response to the day-to-day problems associated with chronic illness
3
Long, Jacqueline Ann. "Exploring how practising mindfulness affects people's experiences of living with a long-term condition." Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/7097/.
Анотація:
There is increasing evidence that mindfulness meditation-based interventions (MMBIs) benefit people with many long-term conditions (LTCs), particularly in terms of psychological wellbeing. Most evidence however relates to short-term outcomes, and limited information exists about how people integrate mindfulness into life over the longer-term, and how this affects their experience. This PhD aimed to address these limitations through the research question: How does practising mindfulness affect people’s experiences of living with a LTC? A qualitative approach was adopted, using grounded theory to explore the processes of change. Using two-stage interviews, diaries and focus groups, data were gathered from 34 participants and seven trainers of Breathworks’ mindfulness course. Almost all study participants reported a diversity of physical and/or mental health problems, many with multi-morbidity. Fieldwork was supplemented by a subsequent Cochrane-informed overview of systematic reviews and a critical review of qualitative studies of MMBIs. Participants’ experiences were predominantly strongly positive, identifying significant changes in thinking and behaviour. They described in detail how mindfulness had become part of their lives, enabling them to be more effective and responsive in their self-care. Analysis identified a core process and metaphor of ‘Starting where I am’ on an unwanted journey to an unfamiliar place. This highlighted how people become more aware and accepting of their condition and its impact, but able to see it in a wider context, and thus to take appropriate action. The process was represented in five interrelated themes: Getting a new perspective; Feeling equipped to cope; Doing life differently; Seeing a change; and Finding it difficult. Through exploration of existing chronic illness literature, the study suggests that mindfulness is a powerful facilitator of transition, through which people come to terms with challenging life events. Transition is associated with improved, self-directed self-management, which is significant to both people with LTC and healthcare providers.
4
Lunt, Catherine A. "Impact of day care services on older people with long term conditions." Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3025902/.
Анотація:
Background: Day care services support older people with multiple long term conditions (LTC) within the community to age in place. This salient topic is given little attention by researchers. Day care services models are complex and outcomes for service users unknown. In the UK, in response to wider policy reforms local authority models have been outsourced to a range of organisations, including Charitable and Voluntary services. This thesis aims to understand the models of day care provided in the community and the subsequent outcomes for users and their families. Methods: This is an exploratory study comparing outcomes for users across five different service types: firstly comparing day care provided by Paid staff services, Voluntary services and Blended services (provided by staff and volunteers) and secondly comparing services provided in urban and rural areas, with a particular focus on health inequalities. Mixed Methodology was used. Observations using focussed ethnography and semi structured qualitative interviews with staff and volunteers provided a greater understanding of the type of provision. Quantitative measures were used at 3 time points over 12 weeks of attendance with clients new to day care to assess outcomes using tools for health status and loneliness. Findings: Data was collected from nine day care centres across seven services. 94 clients and 16 carers attending day care were recruited. 36 semi structured interviews were undertaken with clients, carers, staff and volunteers at the services. At baseline there were no differences across services types in the numbers of long term conditions reported by service types but there were significant differences between rural and urban services (rural mean LTC 5.2, urban mean LTC 4.2, p0.04). A larger proportion of clients attending Blended and volunteer led services reported a reduction in loneliness. When adjusted for other baseline variables in logistic regression model, likelihood of reduction in loneliness was increased in Blended (OR=2.28) and Voluntary (OR=2.16) services compared to Paid staff service. People using Blended and Voluntary services reported better or same health outcomes across most EQ5D3L domains than Paid services. Observations and interview data suggests that the differences in outcomes at Blended and Voluntary services may be due to the delivery of activities promoting self-worth and facilitating links to the wider community. Conclusion: This thesis concludes that day care provides vital support for frail older people living at home and their volunteers can deliver effective support with favourable outcomes. It is suggested that activities that promote self-worth and provide links to the community may facilitate positive health outcomes and reduce loneliness. Preparation of such activities can be implemented with minimum resources, providing cost effective interventions for providers to deliver.
5
Cheng, Joanna. "The mechanisms of psychological therapy with people with long-term physical health conditions." Thesis, Lancaster University, 2017. http://eprints.lancs.ac.uk/87391/.
Анотація:
This thesis comprises a literature review, a research paper and a critical appraisal of the research process. Qualitative literature was systematically reviewed using a meta-ethnography, with the aim of understanding how people with long-term physical health conditions (LTCs) experience psychological therapies. Thirteen articles were identified. Six themes emerged from the synthesis: i) ‘therapists’ expertise and empathic approach led to positive relationships’; ii) ‘therapy was a safe and neutral space’; iii) ‘therapy prompted change in LTC management’; iv) ‘psychological awareness reduced isolation and increased control’; v) how physical ill health interacts with being able to participate in therapy’; and vi) ‘time-limited therapy did not always match service users’ illness trajectory’. The findings were discussed in relation to the values of psychological therapy for people with LTCs and the current way services are delivered to people experiencing co-morbid mental health difficulties. The research paper comprised a qualitative study using a Discursive Action Model approach, which aimed to develop an understanding of how practitioners and service users construct resources and preferred futures within solution-focused therapy sessions. Eight participant dyads were recruited, formed by pairs of practitioners and service users. Data were collected via audio recordings. Four discourses were highlighted: i) ‘practitioners' use of assumptions drew out resources’; ii) ‘explicit commentaries construct change’; iii) ‘de-contextualising for goal construction’; and iv) ‘removing the blame, effort and failure’. The results highlighted the discursive mechanisms which enabled construction of resources and goals. The trans-theoretical applicability of the discourses, clinical implications and recommendations for future research were discussed. The critical appraisal discusses the importance of discourse in clinical psychology practice. The drivers behind conducting this thesis, strengths and weaknesses of the study, and lastly reflections on future practice in clinical psychology were offered.
6
Caldwell, Ellie M. "Experiences of living with incurable haematological malignancy : a research portfolio." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9881.
Анотація:
This thesis follows the research portfolio format and is carried out in part fulfilment of the academic component of the Doctorate in Clinical Psychology at the University of Edinburgh. An abstract provides an overview of the entire portfolio thesis. Chapter One contains a systematic review of published research investigating the experience of living with incurable forms of haematological malignancy. Chapter Two is an empirical study exploring adults’ experiences of living with follicular lymphoma while being maintained under the ‘watch and wait’ protocol. Both chapters are prepared for submission to the European Journal of Cancer Care, and follow their author guidelines.
7
Crabb, Brooke Evangeline. "Perceptions of the transition to assisted living as a function of psychological well-being, instrumental activities of daily living, and coping: A prospective study." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2439.
Анотація:
This study examined the influence of three predictor variables on perceptions of assisted living: psychological well-being, functional status, and coping strategies. A multiple regression analysis was used to examine the influence of these factors on perceptions of the transition to assisted living.
8
Meron, Tikva. "The meaning of advance directives in the lives of people with advanced long term conditions." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/14600/.
Анотація:
Background: Socio demographic and epidemiological change, together with the availability of medical technology, may prolong the process of dying. Antecedent control over end-of-life care (EoLC) may be sought by making an advance directive (AD). This option has been legalised in some countries including Israel, the setting of this study. In Israel, EoLC is set in the context of complex and interrelated religious and state regulations. Aim: To examine from a variety of perspectives, the experiences, beliefs and practices associated with the use of ADs in Israel, with a view to understand their role in the lives of patients with palliative care needs towards the EoL. Methods: The study was conducted in 2011, using mixed methods in two phases. The first phase involved qualitative methods to construct patient-centred case studies. Twenty seven participants (patients, relatives, physicians and a Rabbi) were interviewed. In phase 2, a survey examined health care providers’ (HCP) knowledge, attitudes and experiences regarding ADs. The final sample (n=72) of HCPs comprised: 57 nurses (79%), 8 physicians (11%), and 7 social workers (10%). Findings: This study promotes the understanding that ADs reflect a multitude of steps that are distinct but linked, as in a ‘relay’. The findings demonstrate complexity: patients’ ADs reflected their desire for autonomy but their decisions were often influenced by their relationships. In turn, relatives feared making mistakes in decision-making, while also feeling obligated to enact the patient’s wishes. Physicians reported finding it difficult to forgo active treatments and found communication with relatives about patients’ ADs challenging. The survey showed that while HCPs had typically positive attitudes towards, and some experience with ADs, they also perceived some barriers towards their use. Conclusion: ADs seem as an imperfect solution to the complexities surrounding EoLC planning, and additional solutions than those available today may be required.
9
Franks, Jeannette Searle. "Residents in long-term care : a case-controlled study of individuals in nursing homes and assisted living in Washington State /." Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/11194.
10
Crick, Michelle. "The Role of Regulation in the Care of Older People with Depression Living in Long-Term Care in Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39114.
Анотація:
In this thesis, the overall purpose was to investigate the role of regulation in the care of older people with depression living in long-term care (LTC).
The first manuscript in this thesis is a systematic scoping review protocol which was published in BMJ open, using Arksey and O'Malley's scoping review methodology as a guide. In the second manuscript which was submitted to BMC Geriatrics, a systematic scoping review was conducted, exploring the concepts of regulation, older people, depression, and long-term care. The search yielded 778 unique articles, of which 21 were included in the final analysis. The scoping review revealed that the highly regulated environment of LTC poses significant challenges which can influence the quality of care of residents with depression. Despite evidence of high prevalence and improved treatment, regulation appears to have failed to capture best practice and contemporary knowledge. The scoping review demonstrated a need for further empirical research to explore these issues.
Findings from this study, which explored the role of regulation on the quality of care of older people living with depression in LTC are presented, and which were the basis of the third manuscript, to the Canadian Journal of Aging. Using instrumental case study methodology, I interviewed managers, staff, informal carers and residents, and reviewed documents and clinical charts. I found that Ministry of Health and Long-Term Care regulations influenced strategic planning, educational priorities, resourcing decisions and direct care. The findings from the study suggest an alternative approach to regulation is needed in this sector, which places accountability for standards of care at a provincial level and which has a more supportive and collaborative approach to regulations. The research findings showed that the staff working in the LTC home are committed to the care of residents with depression, but they had little time to implement additional quality initiatives outside of the identified mandated areas. The study concludes by suggesting that in its current state, the care of residents with depression in LTC homes is not reflected in Ministry of Health and Long-Term Care regulations and inspections, which make little difference to the care of older people living with depression living in LTC.
In contributing to the existing knowledge and practice the study along with the findings from the scoping review, finds an alternative model of inspection could be implemented in partnership with the province. An alternative approach to inspection might adopt an extended approach to quality, along with an individualized approach to inspections to meet the requirements set out in regulation, but at the same time offering flexibility and a more collaborative approach to improving quality in the LTC sector.
11
Fossum, Tracy-Lynn A. "Reasons for choosing community versus institutional long-term care for frail elderly people living with their spouses." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ52899.pdf.
12
Pullin, Laynie Dominique Hall. "Living with and providing support to people with spinal cord injury: experiences of long-term family carers." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/13698.
Анотація:
This grounded theory study explores the experiences of partners and other long-term family carers living with and supporting a person with a spinal cord injury. Most research in this area has focused on this experience during the first five years post injury. This study focuses on the experiences of family carers beyond that five-year period. The study aimed to shed light on the daily lives and caring responsibilities of family carers and to explore the extent to which they perceived they were supported by health and social services. Data collection methods included in-depth interviews, a focus group and an online research blog. Data analysis was conducted concurrently with data collection with the goal of developing theoretical conceptualisations of carer experiences. Findings revealed that the experience of long-term caring is all-encompassing and lifelong. This is conceptualised as lifetime, active caring which involves protective, negotiated, surreptitious and strategic caring. This thesis explicates the experiences that are involved for carers in this situation, and the ways in which various aspects of care are interwoven and embedded within the daily lives of carers and their families. The thesis also draws attention to the perceived support needs of long-term family carers in this context.
13
Bramwell, Donna Louise. "Exploring the role of employers and managers in supporting people with long-term conditions in the workplace." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/exploring-the-role-of-employers-and-managers-in-supporting-people-with-longterm-conditions-in-the-workplace(bd30cd6b-6a7d-47d8-9650-1e85a8e85c37).html.
Анотація:
Background: Evidence from the employee perspective frequently suggests that unsupportive managerial relations present a considerable barrier to those with long-term health conditions (LTCs) both on their ability to sustain employment and manage their condition at work. However, little is empirically known about employers’ and managers’ experiences of supporting those with LTCs, or indeed about their perception of their supportive role in the social context of the workplace on which employees suggest they depend for workplace success. This presents a disparity in understanding the contribution of the management role in influencing the (re)entry process to employment for those with LTCs. This is important to explore in light of ongoing objectives by the UK Government to move people with LTCs off incapacity benefits and back into the labour force, as any successful return to work will largely be influenced by employers’ and managers’ readiness to support them. Method: A qualitative approach informed by Grounded Theory principles to guide data collection and analysis was taken for this 3½ year study (September 2009 to March 2013). 40 semi-structured in-depth interviews were conducted with employers and managers from a range of organisations in the North West of England and analysed thematically. Findings were interpreted in relation to a framework of sociological theories of emotion and work. Results: Regardless of industry type, sector and size or condition, several themes emerged which contributed to a sense of burden and tension for participants in supporting those with LTCs. These included discerning legitimacy and tangibility of conditions, having difficult conversations with employees and the influence of the employees’ personality on support. More significantly, all bar one participant typified their role as one of a difficult ‘balancing’ act of additional and often incompatible demands, pressures and feelings arising from managing a complex and emotive situation many considered non-normative to their everyday role. This was typified by feelings of conflict and emotional discomfort, interpreted as ambivalence, stemming from contradictions between and within the normative expectations of their social roles and appropriate feeling rules. For example between the obligations of the professional ‘public’ managerial role in providing value to the organisation, and philanthropic concerns for the welfare of the employee concomitant with their personal ‘private’ role as an individual. Interpreted from a combination of both spoken word and ‘unsaid’ gestures, is the emotion management conducted by managers to cope with negative feelings of ambivalence in a culture which favours rationality over emotionality. Conclusion: Overall, findings indicate that participants in this study concur with the employees’ perspective as to the importance of socially supportive managerial relations. However, it is theorised that managing the emotions of ambivalence serves to undermine manager’s capacity to translate intention to provide support into tangible action, and hence is reflected in the employee’s perception of unsupportive relations. It is suggested that this research could be used to inform the development of a potential intervention to support managers in their pivotal role in the return-to-work process, being beneficial for all stakeholders - the Government, employees and employers alike.
14
Marquis, Ruth. "The meaning of quality in living service environments: An analysis of the experiences of people with disabilities, elderly people and service workers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/976.
Анотація:
The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.
15
Rode, Paulina. "The Hardtowners : an ethnographic study focused on a group of long-term unemployed one-parent families living within a Dundee council estate." Thesis, University of St Andrews, 2004. http://hdl.handle.net/10023/14334.
Анотація:
This is an ethnographic description and investigation of life on a Scottish council estate. It is based on five unemployed one-parent life histories focusing on their experiences, knowledge and emotions in and around a local community centre. The study's expressed focal point is the Gentleman Robber community centre, within the hardtown community in the city of Dundee. The study touches on locally important representations and key issues such as: work, morality, boredom, kinship, spatiality and violence. At the tables in the community centre, the local narrative montage often focused on the enjoyment of violence or the negative marginal stigmatism faced, while, for example, collecting one's social benefits or attending the local doctor. It reflected a dichotomy of Us/Them relations linked to a local fragmentation of identity and issues of deservingness. I found that in a daily emphasis of their own exclusion the Hardtowners often voiced a feeling and embodiment of opposition through local story telling. It is a fragmented and stressful everyday life, with individual skill and network connections deciding individual status in the community. Links and networks last for as long as they are deemed useful and flexibility in trading, cooperation, networking and violence is one of the local guiding lights for success. The ethnographic narrative is described though a fragmented, contextually faithful discourse, with cinematic influences. This imparts a slice of daily experientialism found in the fragmented and stressful lives of the individuals born into and living on benefit in a Western European welfare society.
16
O'Shea, D. J. "Increasing home practice engagement during a mindfulness-based intervention for people with long-term conditions : an exploratory randomised controlled trial." Thesis, University of the West of England, Bristol, 2019. http://eprints.uwe.ac.uk/38141/.
Анотація:
Background: Regular and sustained mindfulness practice (home practice) is considered a key component by which mindfulness-based interventions (MBIs) exert their positive effects (Parsons, Crane, Parsons, Fjorback, & Kuyken, 2017). However, participants often report struggling with home practice during and following MBIs (Jon Kabat-Zinn, 2017a). As such, this study explores whether the addition of a narrative health communication intervention (MABIL in the City) to an existing MBI could support participants home practice during and following the intervention. In addition, this trial aimed to explore whether greater engagement with home practice led to better outcomes immediately following the intervention and at follow-up. Design: The study adopted a single-blind randomised controlled design. Participants were randomised to either an experimental group (MBI + 'MABIL in the City') or an active control group (MBI). Method: Forty-four adults with at least one long-term health condition, were included in the trial. Participants in both groups completed a battery of mood & mindfulness questionnaires including the PHQ-9; GAD-7 & FFMQ-SF (Bohlmeijer, Klooster, Fledderus, Veehof, & Baer, 2011; Kroenke, Spitzer, & Williams, 2001; Spitzer, Kroenke, Williams, & Löwe, 2006) at the beginning, end and 3-months following the intervention. In addition, participants in both groups completed weekly home practice logs. Results: There was no statistically significant association between group and frequency of practice (³ 3 days of < 3 days) during the course, p = .705, or at follow-up, p = .743. Finally, no statistically significant differences in PHQ-9, GAD-7 & FFMQ-SF ratings were observed for participants who practiced on average ³ 3 days a week during the course compared to participants who practiced on average < 3 days a week during the course. However, 3-months following the intervention, participants who reported practicing on average ³ 3 days a week had statistically significant improvements in PHQ-9 & GAD-7 ratings compared to participants who practiced less frequently i.e. < 3 days a week, p = .039., d =.79 (medium effect; Cohen, 1988), p = .047., d =.82 (large effect; Cohen, 1988). Conclusions: Overall, MABIL in the City failed to increase participants home practice engagement as intended. However, the finding which indicated that participants who practiced more regularly 3-months following the intervention had greater improvements in PHQ-9 and GAD-7 ratings compared to participants who practiced less frequently is an important finding which provides support for the value of ongoing mindfulness practice - however these findings should be interpreted in light of the studies limitations.
17
Dysart, Laura. "Health over time : an investigation into the relationship between the future and health behaviours for people with long-term conditions." Thesis, University of Aberdeen, 2018. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=239217.
Анотація:
Long-term conditions (LTCs) are a leading cause of morbidity and mortality worldwide. Health behaviours are a component of many self-management regimes. However, adoption of health behaviours for people with LTCs is relatively low. The purpose of this thesis was to explore the role of the future as it influenced the decision to invest in health for people with LTCs. Specifically, I examined the association between the time discount rate and economic insecurity to explore how the future influences health behaviours. In the first empirical chapter, I found that the time discount rate was associated with maintained physical activity participation but not healthy eating or low-risk alcohol consumption in older adults who have at least one LTC. In the second empirical chapter, I found economic insecurity, which is the anxiety produced from an unsafe financial future, was associated with smoking in older women and physical activity in older men. In the final empirical chapter, I explored how health itself may influence perceptions of the future by investigating the effect of a lagged health shock on the time discount rate in a sample of Danish adults. I found positive health shocks were associated with becoming more future-oriented in women at the 90% significance level and more present-oriented in men at the 95% significance level. The findings of this thesis may be used in the development of policy and interventions to support commencement and adherence to self-management regimes for people with LTCs.
18
McCullough, Kelly A. "Quality of life : its relationship to the identification and incorporation of life strengths in case management of long-term care clients." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1178342.
Анотація:
The purpose of this study was to explore the effect an intervention, based on responses from a Life Strengths Interview questionnaire (LSI), has on the quality of life of elderly persons receiving private pay home care. A total of 12 subjects for this study were recruited from Cardinal Health Systems (CHS) Home Care service. This research employed a basic pretest posttest quasiexperimental design, with one experimental group and one control group. Subject selection was not randomized; however, subjects were randomly assigned to either the experimental or control group. Subjects in the experimental group completed the LSI pre-test and subjects in both groups completed the Quality of Life Index (QLI) pre-test and post-test, as well as a posttest care questionnaire. Data from eight subjects were coded and entered into a database; however, due to the small sample size, statistical analysis of responses from the QLI could not be performed. The primary thematic issues identified through qualitative data analysis indicate that home health aide services positively contribute to client quality of life, and that private-pay clients of CHS Homecare are currently satisfied with their quality of care. Qualitative results gathered by this study support future research efforts to explore the relationship between home care services and client quality of life. More specifically, this study can serve as a pilot for researchers interested in exploring the effects of a LSI intervention on clients receiving home care.Fisher Institute for Wellness and Gerontology
19
Quinn, Hayley Danielle. "A Place to Call My Own: Understanding the Experience of Home for Young People with Disabilities Living in Long-Term Residential Care." Thesis, Griffith University, 2013. http://hdl.handle.net/10072/367867.
Анотація:
This exploratory study was based on a new model of residential care that was designed specifically to provide a home-like environment to young people with severe disabilities and complex chronic healthcare needs (i.e., Multiple Sclerosis (MS) and Acquired Brain Injury (ABI)) to allow them a more appropriate and dignified lifestyle. In 2006, there was an estimated 6,500 people with disabilities under 65 years of age living in residential aged care in Australia (Australian Bureau of Statistics; ABS, 2008). These living environments have been found to be inappropriate and inadequate for young people with disabilities (Cameron et al., 2001; Winkler et al., 2006), particularly given that they may not require 24-hour nursing care.
It is important to consider the nature of home in more detail when thinking about living environments for marginalised groups of people (e.g. people with disabilities), especially as it has been found that the nature of home can impact on the quality of life (Annison, 2000). In order to understand the meaning of “home” for a group of people who live within a particular environment, it is essential that we seek to understand the perceptions of those individuals. In order to provide optimal services, the subjective experience needs to be heard and understood.
The current research was conducted in accordance with Interpretative Phenomenological Analysis (IPA). This method allowed the research to retain the voice of the service users at the forefront and ensured that their views remained paramount. Multiple domains of home, as they were experienced over time, were examined through a series of semi-structured personal interviews conducted with seven residents with either MS or ABI at their residential care setting. The study aimed to understand the residents’ ‘lived experience’ within the residential apartments, and specifically to answer the following questions:
1) How do residents experience home within a residential care setting? and;
2) What influences their sense of home?
Two core themes emerged from the data, namely Perceived Qualities of Place and Identity. These themes seemed to be inextricably interlinked with each other, and to the extent that they overlapped, a sense of Home was created. These two core themes
were influenced by a core process that took place for this group of residents, namely,
Deconstruction and Reconstruction of their sense of home. The core process was influenced by the theme of Connections. Connections was constructed from three sub-themes: Interactions with the physical environment, Relationships with family and
friends, and Relationships with staff. These themes influenced the way in which deconstruction and reconstruction occurred as well as the nature of identity and the perception of place.
The current study produced four major findings. First, connections appeared to be paramount to the development of a sense of home having an influence in multiple ways. Although previous research has linked the importance of social relationships to general well-being and quality of life, the current study has found that these perceptions of relationships also impacted on the participants’ sense of home. Positive relationships, particularly with staff, created a sense of belonging and comfort that assisted in the reconstruction of their sense of home. Interactions between participants and family were especially critical to the participants’ sense of home.
Second, the sense of home emerged as an important concept that is comparative, temporal, tenuous and vulnerable to deconstruction, and needs to be considered by service providers. Deconstruction appeared to take place more rapidly than reconstruction, highlighting the importance of prevention. Home was a vulnerable construct that could be easily destroyed through negative interactions with the physical environment and/or interactions with others. Third, the construct of home was intimately linked to the sense of identity. It is important for service providers to appreciate these linkages and respond accordingly. This type of information is rarely used in relation to the design and provision of services in environments that provide long-term care for young people with chronic and complex health needs. Finally, this
study has built a theory that shows the link between the existing models of home proposed by Despres (1991). Although these models have been proposed as four distinct conceptual approaches to home, this study has highlighted that they do not operate in isolation. Instead, home is a multi-dimensional construct that is influenced by many factors. It can be influenced by connections, perceived qualities of place and identity. However, identity needs to be congruent with a sense of belonging. Identity needs to be a construct that becomes more focal in service delivery.Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
School of Applied Psychology
Griffith Health
Full Text
20
Karachaliou, Dimitra. "Investigating and addressing barriers to the effective recognition and management of depression in people with long-term conditions in primary care." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/investigating-and-addressing-barriers-to-the-effective-recognition-and-management-of-depression-in-people-with-longterm-conditions-in-primary-care(689b0b52-7a95-4f40-b8ca-3faf11585edf).html.
Анотація:
Objectives: Depression is often unrecognised or sub-optimally treated in primary care. This has led to research exploring the barriers and enablers to effective recognition but little is known about health care professionals’ (HCPs) beliefs or personal illness models about depression in patients with long term conditions (LTCs), the presence of which may affect recognition and management. Using Leventhal’s Common Sense or Self-regulatory Model this thesis aimed to: explore HCPs’ illness representations and management in people with LTCs and depression; to understand the role of personal models and perceived barriers to depression recognition and management; and to address them in a theory-based online training intervention. Methods: This thesis was undertaken in three stages; a scoping review with narrative synthesis was conducted to explore the role of HCPs’ personal illness models of depression, a qualitative study using semi-structured interviews with 16 HCPs to investigate their illness beliefs about depression in patients with LTCs and finally, the development and feasibility assessment of a theory-based online training intervention to target HCPs’ attitudes, beliefs and self-efficacy. During this stage a new measure of HCPs’ beliefs and attitudes towards depression in patients with LTCs was developed as no appropriate measures were currently available to capture HCPs’ personal illness models of depression as a comorbid condition. Results: Twenty-seven papers were included in a mixed method scoping review. The review concluded that HCPs mainly normalised depression but lacked a complete conceptualisation of depression in primary care. HCPs reported time constraints and lack of skills as important barriers to recognising of depression in primary care. Negative attitudes towards depression and lack of confidence to recognise and manage depression were also commonly reported. In the qualitative study, the main themes were; 1) Recognition of depression in people with LTCs is complex (unclear illness identity) 2) Attitudes towards recognition and management of depression in people with LTCs act as either barriers and enablers to depression management 3) The necessary level of condition-related knowledge and understanding of depression in the context of a LTC 4) Controllability of depression in people with LTCs. The findings suggested that HCPs’ illness beliefs about depression in people with LTC varied in crucial ways with some participants prioritising the management of the LTC or expecting patients with diabetes or CHD to diagnose depression themselves due to time constraints. Some HCPs also reported simplistic views of causation which appeared to impact on their decisions whether or not to detect depression in people with LTCs. The findings of the qualitative study were used to inform the content of a novel online training intervention using illustrations to facilitate engagement. Thirty one HCPs were recruited and 15 completed the evaluation. The results of the feasibility study suggested that the method, context and mode of intervention was feasible but the lack of validated measures and the small sample size hinder conclusions about changes in participants’ illness beliefs, intentions, self-efficacy and perceived barriers towards depression. Comments: The scoping review study provided new insights into why HCPs may not engage with detection of depression but only a limited amount of research has explored HCPs’ beliefs about depression in patients with LTCs. The qualitative study addressed this and contributes new knowledge about the way HCPs conceptualise depression in patients with LTC and was used to design an online intervention to improve the management and recognition of depression in these patients. Further research to develop this intervention and evaluate it on a larger scale is needed.
21
Hadert, Aimee. "Adapting cognitive behavioural therapy interventions for anxiety or depression to meet the needs of people with long-term physical health conditions : a mixed-methods study." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/13705.
Анотація:
Objective(s). An increasing demand exists for psychological interventions to increase recovery from depression and anxiety in people with long-term physical health conditions (LTCs). Guided self-help (GSH) may meet this need, however, there is limited evidence of GSH’s appropriateness for people with LTCs. Design. A mixed-methods study using qualitative interviews with people with stroke and Chronic Obstructive Pulmonary Disease (COPD), and a quantitative survey of professionals who support guided self-help, explored opinions about whether self-help is appropriate, and whether suggested adaptations varied across LTCs. Results. Opinions varied about the appropriateness of standard self-help and adaptations required. Illness beliefs may help explain differences between the two LTCs and individual interviewees. The majority of professionals surveyed felt competent supporting people with LTCs, and reported having access to appropriate self-help material. Conclusions. Recommendations for improving the appropriateness of contents of guided self-help for people with LTCs are provided. Supporting professionals need relevant knowledge and skills to integrate information about the LTC into the intervention, and offer flexible, personalised delivery to support participation.
22
Robinson, Lisa. "Self-management and adherence with exercise-based falls prevention programmes for older people with long-term conditions : a framework for physiotherapy practice." Thesis, Northumbria University, 2012. http://nrl.northumbria.ac.uk/8448/.
Анотація:
Introduction: This study aimed to work with older people attending a regional falls and syncope service, older people with the falls-associated chronic liver disease primary biliary cirrhosis, relatives and local physiotherapy practitioners to develop a framework for physiotherapy practice to promote self-management and adherence with an exercise based falls prevention programme for older people with a long-term condition. Methods: Focus groups were conducted with older people attending a regional falls and syncope service (3 groups, total 12 participants), relatives (1 group, total 4 participants) and local physiotherapists (4 groups, total 18 participants). Participants were asked to propose strategies to promote self-management and adherence with an exercise-based falls prevention programme. These strategies were tested and refined in an experimental case-series for 10 older people with primary biliary cirrhosis. Findings: The older people participating in the focus group research expressed a long-term commitment to exercise-based falls prevention programmes. They valued approaches that promoted self-efficacy and self-management. The physiotherapists indicated that the older people they came into contact with were poorly motivated to participate in an exercise-based falls prevention programme. They demonstrated a limited awareness of strategies to promote self-efficacy and self-management. Visual analysis of the experimental case-series data revealed unstable baselines and fluctuations throughout the treatment and follow up phases in keeping with variations in disease-specific quality of life measures, suggesting that long-term conditions interact with measures that predict and monitor falls-risk and self-efficacy. The exercise-based falls prevention programmes had perceived benefit for older people with primary biliary cirrhosis. However, this was not evident in the measures selected, many of which demonstrated a ceiling effect in the population group under investigation. The self-management strategies had low levels of perceived acceptability. Participants indicated that they lacked the necessary skills to monitor their progress with an exercise-based falls prevention programme on completion of the experimental case-series. Conclusion: This study demonstrated that self-management does not sit comfortably within the philosophy of routine clinical practice. The framework for physiotherapy practice developed during the course of the current study has the potential to empower physiotherapists and older people with long-term conditions identified as being at increased risk of falling to work in partnership to challenge existing approaches to clinical service delivery.
23
Galinsky, Jayne. "A grounded theory study of dream fulfilment in children and young people with life-threatening and long-term conditions and their families." Thesis, University of Stirling, 2015. http://hdl.handle.net/1893/23180.
Анотація:
Background: This thesis examines the impact of dream or wish fulfilment on seriously ill children and their families. Dream or wish fulfilment is operationalised as the actualisation of a seriously ill child’s wish by a charity that provides desired experiences. Anecdotal reports suggest that the experience of having a dream or a wish fulfilled can provide seriously ill children and their families with a sense of hope and time away from illness. However, little empirical research has been conducted in this area. This thesis reports the impact of dream fulfilment on the psychosocial well-being of ill children and their families. The research questions are: what is the experience of having a dream fulfilled for the child? What is the impact of dream fulfilment on the family? Methods: A constructivist grounded theory methodology was adopted, using theoretical sampling to recruit families from across the UK. Twenty-one families were interviewed, including 15 dream recipients, 8 siblings, and 24 parents. Analysis followed the grounded theory methodology of simultaneous data collection and development of theory, resulting in analytic interpretations of participants’ worlds. Results and Conclusions: This thesis reports for the first time a theory and accompanying theoretical model, that explain the impact of dream fulfilment on families’ lives. The generated theory suggests that dream fulfilment was conceptualised as an alternative milestone in seriously ill children and their families’ lives. Additionally, the dream experience shifted perceptions of illness by providing instances and experiences where illness did not underscore family life. Findings additionally suggest that the dream fulfilment process provided families with ill children, who often felt excluded and stigmatised from services, with a period of much needed support. Findings also highlight the unintended negative consequences of dream fulfilment. Implications for Dreams Come True, and other dream and wish fulfilment organisations are discussed.
24
Hadi, Monica. "Specifying the dimensions of care that matter to people with long-term conditions (LTCs) and improving our understanding of patient-centred care (PCC)." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:6697677c-e747-4345-a746-6038db12019f.
Анотація:
Background The term patient-centred care (PCC) is commonly used in the academic literature and UK health policy. However, this concept is ill defined and little is known about its applicability to the management of people with long-term conditions (LTCs). Several methodologies were used to explore the meaning of PCC, identify key experiences that matter to people with LTCs and consider the implications of these findings for the measurement of patient reported experiences of health care. Method Four stages of research were conducted for this thesis. First, a conceptual synthesis of existing PCC and patient experience frameworks to produce an overarching framework of PCC. Second, secondary qualitative analysis of patient interviews to identify key experiences of PCC that matter to people with LTCs. Third, development of a PCC questionnaire for people with LTCs, based on findings from the conceptual synthesis and secondary analysis. Fourth, further exploration of the questionnaire through cognitive debriefing interviews with people with LTCs and health professionals. Results The overarching framework of PCC consisted of 8 domains; access, availability and choice, information, communication and education, relationship with health professionals, involvement in care, respect and dignity, responsiveness to individual needs and preferences, consistency, continuity and co-ordination, and effectiveness of treatment and care. Findings from secondary analysis suggested that many of the domains from the framework were also important in care for people with LTCs, but that some aspects of care held an additional meaning. The themes identified in the secondary analysis were used to generate items for a generic PCC experience questionnaire for people with LTCs. The final questionnaire, ‘Your Experiences of Care in Long-Term Conditions’ consisted of 47 questions across three sections. Feedback from the debriefing interviews suggested that the questionnaire had asked important questions about care for people with LTCs and that it was relevant to people with a range of different LTCs. Conclusion Development of an overarching framework of PCC demonstrated some conceptual problems in understanding and evaluating the notion of PCC. Findings from this thesis suggest that an overarching questionnaire of experiences of PCC is feasible and acceptable to people with a range of different LTCs. Future research needs examine standard features of the newly developed PCC experience questionnaire for people with LTCs and consider the potential use and contribution of data in enhancing care for people with LTCs.
25
Annesley, Sarah H. "A qualitative study of policy and action : how the Scottish Government has implemented self-management support for people with long-term conditions (LTCs)." Thesis, University of Stirling, 2015. http://hdl.handle.net/1893/22370.
Анотація:
Objective: The promotion of self-management support for people with LTCs is a health policy priority across the UK (LTCAS 2008; DoH 2012). Self-management support is designed to change and improve care for people with LTCs, who form an increasing proportion of the population requiring healthcare and treatment. For health organisations models of care, which support self-management, require greater emphasis on person-focused rather than disease-focused manifestations of health and represents a new model of care delivery requiring changes in practice. Current research demonstrates that health policies are increasingly complex, involve multiple organisations and often fail to translate into effective practice (Noyles et al. 2014). The deficit between what works and what happens in practice is referred to as the “implementation deficit” (Pressman and Wildasky 1984) and traditionally it has been difficult to breakaway from the idea that the policy process is best viewed from the top-down (Barett and Fudge 1981). However, there remains a need to understand the processes of implementation, which takes account of the variation, the multiple layers and interactions which takes place between policy-maker and -implementer as policy becomes practice (Hupe 2011). Implementation of self-management is a contemporary focus in UK health policy and this thesis explains what processes are used to implement self-management policy for people with LTCs into everyday practice in one health board. Methods: A case study approach was used to investigate the policy process with data collected using thirty-one semi-structured interviews with policy-makers and regional and local policy-implementers plus eight hours of observation of national and regional policy meetings. To provide context to the implementation process data also included thirteen policy documents. Data analysis used the retrospective application of NPT as a theoretical framework with which to explore the implementation processes. NPT is an emerging theory that is being promoted as a means of understanding implementation, embedding and integration of new ideas in healthcare (McEvoy et al. 2014). The application of NPT focuses on four mechanisms, termed work (May and Finch 2009: 547), which promote incorporation of new ideas in practice. These areas of work are coherence, cognitive participation, collective action and reflexive monitoring (Mair et al. 2012). Findings: The findings suggest that there are a number of important influences operating behind or as part of the policy implementation process. These included the need for a shared understanding, getting stakeholders involved to drive forward policy, work promoting collaboration and participation was the most detailed and important in the process of policy implementation; the course of policy was affected by factors which facilitated or inhibited stakeholders acceptance of self-management; and NPT fosters key analytical insights. Conclusion: Understanding the process of policy implementation in healthcare and how practice changes as a result of policy is subject to a wide range of influences. What emerges are five key recommendations relating to understanding policy implementation. (1) understanding the concept of self-management is important in promoting policy implementation. This understanding benefits from dialogue between policy-makers and -implementers. (2) stakeholder involvement supports implementation particularly the role of clinical leadership and leadership through existing networks but also value in establishing new organisational structures to create a receptive context. (3) develop participation and collaboration through use of the patient voice which helped simplify the policy message and motivate change. (4) other resources help policy implementation and where these are evident then policy is implemented and where they are absent then implementation is not embedded. Lack of evidence was a particular area of constraint. (5) NPT has shown that social context is important, and provides for this. But in addition there is evidence that historical perspectives and previous experience are also important influence on receptivity to implementation. This research contributes to the development of theory and practice in the area of implementation science. The exploration of the policy implementation has revealed the action and work which policy-makers and -implementers are engaged in while implementing policy. It has tested the utility of NPT in a real-life setting using all four mechanisms.
26
Walsh, Jeremy. "Contemporary dynamics of caring : a qualitative study of the relationship between mental health professionals and carers of people with long term mental health conditions." Thesis, University of East London, 2015. http://roar.uel.ac.uk/4983/.
Анотація:
At the heart of this study is the experience of caring for someone with a long term mental health condition and the relationship between mental health professionals and carers, who are largely family, partners or friends. The study has been conducted at a time when there is increasing awareness of carers but at the same time limited understanding of the day-to-day lives of people caring for someone with a mental health condition. Using a psychoanalytically informed psychosocial approach seven carers and eight mental health professionals were interviewed using a free association narrative interviewing approach, which provided a framework for participants to share their experiences. In the next phase a combined focus group of 16 participants was held, comprising nine carers and seven mental health professionals and vignettes were utilised to facilitate discussion. Data from both methods was analysed using a reflexive and psychoanalytical approach which encouraged the emotional response of the researcher to be taken into account. Alongside, a thematic analysis was undertaken to enable cross-referencing. The study found that the disturbing nature of mental health conditions directly affects carers and mental health professionals, and within this environment carers place high value on support that is built on a meaningful relationship with a mental health professional. However this is not always available as professionals seek to defend themselves from the distress that is bound up in the caring experience, and therefore they idealise carers and maintain professional distance, with the result that carers’ anxiety is not dealt with effectively.
27
Bífárìn, Oládayò O., Catherine Quinn, Liz Breen, C. Wu, M. Ke, L. Yu, and Jan R. Oyebode. "Stressors and coping mechanisms of family care-givers of older relatives living with long-term conditions in mainland China: A scoping review of the evidence." Cambridge University Press, 2021. http://hdl.handle.net/10454/18567.
Анотація:
YesAs the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers’ unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China.
This work was supported by Research England: Quality Related Global Challenge Research Fund (QR-GCRF).
28
Hsu, Chen-Yuan. "The Effect of Tai Chi on Quality of Life of Older People Living in Long-Term Care and Using Wheelchairs for Mobility: A Randomized Controlled Trial (RCT)." Thesis, Griffith University, 2013. http://hdl.handle.net/10072/367582.
Анотація:
The ageing process results in a range of debilitating physical and psychological conditions. As a result, older people are increasingly residing in Long-Term Care (LTC) facilities and using wheelchairs to assist in independence and maintenance of their daily activities. The use of wheelchairs to aid mobility has the potential to negatively influence the quality of life (QOL) of such people living in LTC and in particular factors related to QOL, such as psychological well-being (depression and mood states) and self-efficacy. In spite of this, there has been limited research on the QOL of older people using wheelchairs for mobility. Most of the studies available focus on the factors influencing QOL and there is a paucity of research that explores the influence of an exercise program on the QOL of older people using wheelchairs.
This study, using a randomized controlled trial (RCT) approach, explores the impact of a 26-week seated Simplified Tai Chi exercise program (STEP) (Chen et al., 2006) on QOL, depression, mood states and self-efficacy of Taiwanese older people living in LTC who use wheelchairs. The randomization, STEP seated Tai Chi intervention and RCT design are powerful methods to examine the effect of the seated Tai Chi exercise. A sample of people was recruited, 30 in the experimental group and 30 in the control group. The baseline data were collected using the World Health Organization Quality of Life BREF (WHOQOL-BREF), Geriatric Depression Scale-Short Form (GDS-SF), Profile of Mood States Short Form (POMS-SF) and Self-efficacy for Exercise Scale (SEE), with follow up measurements collected in weeks 13 and 26.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
Full Text
29
Trick, Leanne Victoria. "The role of perseverative negative thinking in predicting depression, anxiety and quality of life in people with coronary heart disease." Thesis, University of Exeter, 2017. http://hdl.handle.net/10871/29314.
Анотація:
Depression is common in people with coronary heart disease (CHD) and is associated with worse physical outcomes. The nature of the causal association between CHD and depression, and the mechanism underpinning the association of depression with worse physical outcomes, remains unclear. Perseverative negative thinking may contribute to the development of depression in people with CHD. The aim of this thesis was to investigate the prospective association of perseverative negative thinking with depression, anxiety and worse physical outcomes in people with CHD, and to explore factors that may mediate this association. First, a systematic review identified 30 studies, of which the majority found an association between measures of perseverative negative thinking and subsequent depression, anxiety or emotional distress in people with long term conditions. Studies that controlled for covariates showed more mixed results, though the majority (15 / 25) still supported a significant association, with effects being small in magnitude. Findings were limited mainly to the association of rumination and/or catastrophizing with subsequent depression, and study quality was limited. Next, in an observational prospective cohort study 169 inpatients and outpatients with recent acute coronary syndrome (ACS) completed self-report assessments of rumination (Ruminative Responses Scale brooding subscale), worry (Penn State Worry Questionnaire), depression (Patient Health Questionnaire-8), anxiety (Beck Anxiety Inventory), and health-related quality of life (EuroQol-5D health-related quality of life, Seattle Angina Questionnaire) after hospitalisation, and at 2 month and 6 month follow-up. Additionally, assessments of potential mechanistic factors (social support, problem solving, instrumental behaviours and negative cognitive biases) were made. Baseline brooding was a significant independent predictor of depression at 6 months after controlling for the effects of important confounding variables, accounting for 2% of the variance. Findings suggested that the association of brooding with depression may be explained by deficits in problem solving ability. Rumination and problem solving may provide useful targets for the development of evidence-based interventions to improve depression among people with CHD, although the findings presented here fall short of proving a causal relationship. Future trials could be used to investigate the causal nature of the association of rumination and problem solving with depression in people with ACS.
30
Amini, Reza. "Health-related Quality of Life and Social Engagement in Assisted Living Facilities." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804930/.
Анотація:
This research project aims to clarify the factors that impact successful aging in Assisted Living facilities (ALFs) in Denton County, Texas. We hypothesize that social disengagement decreases physical and mental components of quality of life. This exploratory research project employed standardized questionnaires to assess residents in the following domains; HRQOL, social engagement status, level of cognition, depression, and the level of functioning. This study collected data from 75 participants living in five ALFs. The average of Physical Component Scale (PCS) and Mental Component Scale (MCS) was 35.33, and 53.62 respectively. None of the participants had five or more social contacts out of facilities, and two-third of them had two or less social contacts. On average, those participants who were more socially engaged had higher score of MCS compared with disengaged counterparts. The level of physical function significantly affects social engagement, when people with more disabilities are more likely to be socially disengaged. Social engagement and depression significantly impact MCS, when depression is a mediating factor between social engagement and mental component of quality of life. Considering the expansion in aging population in the United States within the next three decades, the demand for high quality long-term care will skyrocket consequently. This study reveals that external social engagement can sustain HRQOL of residents in assisted living facilities.
31
McQueen, Ann Elizabeth. "Humor-Related Social Exchanges and Mental Health in Assisted Living Residents." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/299.
Анотація:
Social contact is known to be vital for older adults' mental and physical health, but few studies of social interactions have taken place in long-term care settings. The current study investigated whether the psychological well-being of assisted living residents was influenced by factors associated with residents' social interactions involving humor. Specific aims of the present study were to develop and test a measure related to humor-related social exchanges, to examine how humor-related social exchanges affect residents' mental health, and to explore whether humor-related social exchanges mediated the effects of resident and facility characteristics on indices of mental health. One hundred and forty older adults residing in 14 assisted living facilities in the Portland, Oregon metropolitan area were interviewed about the frequency and types of social interactions they experienced with members of their facility-based social networks, as well as depression, mood, loneliness, self-esteem, and self-rated health. A 12-item, two-factor model of humor-related social exchanges was identified through confirmatory factor analysis, including both positive and negative humor-related social exchange factors. The newly developed scale displayed evidence of adequate reliability and validly in the current sample. Results indicated that both positive and negative humor-related exchanges were associated with various aspects of mental health, although negative humor-related exchanges appeared to be a stronger predictor of mental health than positive humor-related exchanges. Both positive and negative humor-related exchanges also served as mediators between resident and facility characteristics and indicators of mental health. Cultivating a better understanding of the relationships between humor-related social exchanges and mental health may be beneficial for researchers interested in the way humor impacts older adults' ability to cope with stress. This research may also be of value to long-term care providers who create interventions designed at improving residents' mental health and overall quality of life.
32
Ramos, Jeane da Silva. "Minha vida, meu tempo, minha condição:análise reflexiva sobre idosos na atualidade, centralizando o estudo numa Instituição de longa permanência para idosos." Universidade Catolica de Salvador, 2014. http://hdl.handle.net/123456730/195.
Анотація:
Submitted by Lafaiete Santos Santiago (lafaiete.santiago@ucsal.br) on 2016-11-14T13:31:29Z
No. of bitstreams: 1
RAMOS JS-2014.pdf: 1179431 bytes, checksum: d5b14f6de5911bc146f8a9ef8a0a9ff5 (MD5)Approved for entry into archive by Maria Emília Carvalho Ribeiro (maria.ribeiro@ucsal.br) on 2016-12-28T19:50:53Z (GMT) No. of bitstreams: 1 RAMOS JS-2014.pdf: 1179431 bytes, checksum: d5b14f6de5911bc146f8a9ef8a0a9ff5 (MD5)
Made available in DSpace on 2016-12-28T19:50:53Z (GMT). No. of bitstreams: 1 RAMOS JS-2014.pdf: 1179431 bytes, checksum: d5b14f6de5911bc146f8a9ef8a0a9ff5 (MD5) Previous issue date: 2014-11-07
A discussão que envolve questões da vida humana e da ruptura de alguns conceitos presentes na sociedade pós-moderna põe em discussão assuntos que transcendem análises detentoras de ambiguidades e/ou contradições a serem refletidas e discutidas, as quais conduzem a avaliações sobre a condição do homem inserido no centro das relações sociais. Versando sobre este eixo, “Minha vida, meu tempo, minha condição” tem como principal objetivo realizar um estudo sobre a situação do idoso na sociedade contemporânea em tempos de transformações sociais cada vez mais aceleradas, bem como as alternativas para lidar com tal questão, cujo maior destaque está sob os vieses da dinâmica familiar e do processo de institucionalização. A linha de pesquisa adotada foi baseada na teoria da fragilidade das relações humanas discorrida por importantes pensadores contemporâneos. Para maior compreensão do estudo, se fez necessário utilizar como processo de investigação, revisões e análises bibliográficas e busca em sites que referenciam questões sobre o tema, assim como a observação e descrição empírica, este com o método quanti- qualitativo. Em ênfase a segunda abordagem, é importante destacar que a referida pesquisa foi realizada, através de entrevistas semiestruturadas, com 20 (vinte) idosos, entre 65 (sessenta e cinco) a 85 (oitenta e cinco) anos, de ambos os sexos que residem em uma Instituição de Longa Permanência para Idosos (ILPI), situada no Município de Salvador, Bahia. Permite-se afirmar que tais análises foram pertinentes para o entendimento tanto da vida cotidiana do idoso que reside num local dessa natureza, levando em consideração o diagnóstico da sua condição social atual, quanto da dinâmica familiar em que está inserido. A partir dessa visão vem a seguinte indagação: residir em um abrigo para idosos é uma opção ou resultado de um processo em que se agrega à falta de opção? O que está nas entrelinhas dessa realidade? Quais foram as principais causas que levaram esses indivíduos a decidirem por essa maneira de viver, a se permitir estar nesta condição? Nas reflexões conclusivas, foi possível perceber que a situação atual desses idosos caracteriza uma realidade desafiadora, principalmente quando parte para a visão de que a institucionalização está sob bases complexas e que a família está no pilar desse processo, expressamente colidente. Foi possível perceber, em alguns momentos, a fragilidade desses vínculos, logo, a institucionalização muitas vezes representa uma alternativa para lidar com os reflexos dessa situação, tendo como consequência uma vertente desse fato relativamente aceitável e cheio de contradições. Estes questionamentos foram analisados no decorrer do processo da pesquisa, apontando assim, os limites e as vertentes dessa problemática, merecendo destaque o contexto social contemporâneo vivenciado por esses sujeitos, mais precisamente os que estão inseridos nessa condição, a de idoso abrigado.
The discussion that involves issues of human life and the rupture of some concepts in postmodern society it discusses issues that transcend analyzes holders of ambiguity and / or contradictions to be reflected and discussed, which lead to reviews of the condition of man inserted into the center of social relations. Dealing on this axis, "My life, my time, my condition" aims to conduct a study on the situation of the elderly in contemporary society in times of social change increasingly accelerated and the alternatives for dealing with such matters, whose most prominent is under the biases of family dynamics and the process of institutionalization. The adopted research line was based on the theory of the fragility of human relationships studied by important contemporary thinkers. For better understanding of the study, it was necessary to use as the research process, reviews and bibliographic analysis and search on sites referring to questions on the subject, as well as observation and empirical description, this quantity with the qualitative method. An emphasis on the second approach, it is important to note that this research was conducted through semi-structured interviews with twenty (20) old, between 65 (sixty-five) to 85 (eighty-five) years, of both sexes residing in an institution of for the Aged (LTCF), located in the city of Salvador, Bahia. Lets say that such analyzes were relevant to understanding both the everyday life of the elderly who reside in a place of this nature, taking into account the diagnosis of your current social condition, as the family dynamics in which it appears. From this vision comes the next question: living in a nursing home is an option or result of a process in which adds to the lack of choice? What's between the lines of this reality? What were the main causes that led these individuals to decide for this way of life, to allow to be in this condition? In the concluding reflections, it is noted that the current situation of the elderly features a challenging reality, especially when part to the view that the institutionalization is under complex bases and that the family is the pillar of this process, specifically colliding. It could be observed, at times, the fragility of these bonds, so the institutionalization often represents an alternative to deal with the consequences of this situation, resulting in a shed that fact relatively acceptable and full of contradictions. These questions were analyzed during the research process, pointing thus the limits and dimensions of this problem, a special focus contemporary social situation experienced by these subjects, specifically those that are inserted in this condition, the elderly housed.
33
Moulton, Heather J. "Aging With Long-Term Physical Disabilty: The Role of Secondary Conditions." Thesis, 2014. https://doi.org/10.7916/D8319VSC.
Анотація:
Objectives: The purpose of this study is to advance the understanding of secondary conditions experienced by persons aging with the long-term disabilities of polio and rheumatoid arthritis and the consequences of these declines in health and function on disability bed days. Additionally, it explores the effects of the timing and severity of onset of disability characteristics on the frequency and consequences of secondary conditions. A life course conceptual framework with the Institute of Medicine’s model of disablement is used to frame and anchor disability and life events. Methods: In-depth structured in-home interviews were conducted on 216 individuals with polio and 186 individuals with rheumatoid arthritis. They consisted of objective and subjective self-reports of current status and prior condition. The survey was a regional crosssectional, group comparison design with a cross-sequential sampling and data analytic framework. Scale development for data reduction was utilized to obtain parsimonious measures for the models. Linear regression was then performed to test the models for three outcome variables (number of chronic secondary conditions, increases in functional limitations and number of disability bed days in six months) in a theorized order for the polio and RA samples individually. Results: There was partial support for within-sample hypotheses for both polio and rheumatoid arthritis regarding interrelationships and disability bed days in past six months. No significant differences were found across subsamples for the effects of timing and severity of onset of disability characteristics, predicting chronic secondary conditions, predicting increase in functional limitations, and the number of disability bed days in six months. Similarities were found between the two samples when examining subgroup predictors on the three outcomes above. Chronic secondary conditions predicted (p<.05 for both subsamples) increase in functional limitations and increase in mobility was a significant predictor (p<.001 for both subsamples) of increase in functional limitations. Discussion: There were limited findings for these data. Judgment must be withheld with respect to the hypotheses. The analyses did not yield enough predictive strength to make comparisons possible across subsamples. Likewise, in examining similarities, only general, descriptive statements could be made. The subjective nature of disability is an immense challenge in cross disability research for comparability within disabilities and across disabilities.
34
Hsieh, Ying-Hui, and 謝英慧. "The study of people living with HIV/AIDS(PLWHA)and long-term care risks potential." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/73176535578212516892.
Анотація:
碩士國立臺北護理健康大學
長期照護研究所
103
The long-term care is universal nature of human needs, each person may have LTC demand potential and become the case for a lifetime. Life expectancy prolong due to the introduction of HAART, the population of HIV-infected patients is ageing consequently, and then they come to the aging trend accompanied with chronic change of morbidity, disability-focusing from health and care problem, complicated and long-term shifting of care. It reflected the complex & sophisticated nature of the particular long-term care risks. The purpose of this study tries to explore LTC risks potential among of people living with HIV/AIDS (PLWHA). The study has been conductive by cross-sectional design, with the structure questionnaire, picking up 300 patients as the samples at out-patient clinic this year, by the tool of preventive screening on LTC“the Kaigo-Yobo checklist” in Japan. The study outcome showed that around 57.7﹪of participants might be regarded as LTC in potential encompassing some domains under overall. Some of them with the risk in single domain 67.6﹪,the other might possess two or more. The concluded overall 2.3﹪, other sub-dimension of risk priorities were mobility4.0﹪, nutrition8.3﹪, oral & teeth17.7﹪and depression49.3﹪. The major factors of long-term care risk included co-morbidity index, physical-activity routines and smoking, therefore it is important to promote the preventive long-term health care. The study was the pilot trial to approach PLWHA for preventive long-term health care. Base on the study, might be helpful to afford some supports of polite investigation, it has presented some preliminary results of the reference, but still incapable of concluding rationally, universally, or conclusively. More furthermore studies are still mandatory. Keywords: long-term care、long-term care risks、preventive long-term health care、 People living with HIV/AIDS (PLWHA)
35
LIN, YU-CHING, and 林鈺清. "A Review of the Long-term Care Needs for the Elderly People Living Alone from User’s Perspective." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/gewg5t.
Анотація:
碩士南開科技大學
福祉科技與服務管理所
105
The main purpose of this study is to explore the need for long-term care services for elderly people living alone and to the improvement of their lives. The author uses the Purposive Sampling method to carry on the in-depth interview to the two long-term care workers and the five elderly people living alone who use the service in Guoshing Township, Nantou County. According to the interview to understand the feelings and views of the elderly living alone, and to develop specific recommendations for the relevant units for reference. According to the interview results, (1) they generally do not understand the content of the program., (2) the elderly people living alone agree that services can improve their living conditions, (3) they thinks that in addition to physical satisfaction and the care of the disease, they also need to interact with the community and need people to accompany, (4) they wants to be able to age locally, and the service is provided with their expectation, (5) and the cost burden will affect their willingness to use the services. According to the conclusions, the suggestions are as follows: (1) providing more diversified services and flexible service models, (2) improving message propagating about long-term care services. Keywords：Long-term care, Aging in place, Solitary elderly
36
Amoroso, Bice. "Finding Meaning in Place: The Perspectives of People with Severe Mental Illness Living Long Term in a Psychiatric Hospital." Thesis, 2012. http://hdl.handle.net/1807/32517.
Анотація:
This study explored the perspectives on place of eight people with severe mental illness living, for one year or longer, in an urban psychiatric hospital. The research questions were: how do people with severe mental illness view the psychiatric hospital as place?; and how do they make meaning of the experience of living in hospital. The research employed a phenomenological approach, as described by Giorgi (1985). Using purposive sampling, one time, semi-structured, individual interviews were conducted. The audio recorded interviews were transcribed and thematically coded using Giorgi’s (2005) method. The meanings of the participants’ experiences are captured by the meta-theme: this is not a home; it’s a hospital. Four additional major themes emerged; and each of the major themes also had sub-themes The findings of this study challenged commonly held assumptions on how people living long term in a psychiatric hospital view the hospital as place and on institutionalization.
37
Walland, Emma Jane. "The lived experience of people with brain injury living in long term care facilities: specific implications for social isolation." Thesis, 2017. https://hdl.handle.net/10539/23800.
Анотація:
A research report submitted in partial fulfilment of the
requirements for the degree of Master of Arts in Social
and Psychological Research
to the Department of Psychology,
School of Human and Community Development,
The University of the Witwatersrand,
Johannesburg, South Africa,
2017Introduction. The provision of appropriate long term care facilities for people with acquired brain injury is a portentous issue internationally. There is a global lack of long term care facilities for people with acquired brain injury and they are often placed in facilities for the physically disabled or the elderly. It is unclear whether these facilities are suitable and what effect they may have on well-being and social isolation. Aim. This interpretive phenomenological study explored how adults with acquired brain injury experience living in such long term care facilities. Additionally, it described how such living arrangements impact on social isolation, a particularly devastating psychosocial consequence of acquired brain injury. Method. One-on-one, semi-structured interviews were conducted with seven adults who had acquired a brain injury. Each participant had been living in a long term care facility for at least one year. They were asked questions related to their general lived experience as well as specific questions to explore their experience of social isolation. Findings. Thematic content analysis of the interview data led to the following five categories of themes: overall evaluations (guarded approval, and disapproval); general lived experience (autonomy, choice, freedom, burden, boredom, and basic needs); social isolation (loneliness, companionship, and belonging); sources of isolation (living with the disabled, different disability, age differences, pets, and facility setup); and sources of well-being (positivity, and meaning). The main findings were that the general lived experience of people with ABI was mainly negative. The facilities generally met only basic needs and seldom met higher level psychological needs. Social isolation was commonly reported among residents with ABI in long term care facilities and was linked to age differences and having a brain injury in a facility geared for people with other disabilities. The findings were understood in relation to Bronfenbrenner’s ecological systems theory and Maslow’s hierarchy of needs. Conclusions. The findings of this study contribute towards filling a theoretical gap in understanding the lived experience of people with ABI in long term care facilities and how this contributes to social isolation. The findings have potential value to family members of people with acquired brain injury considering various living arrangement options. They can also be useful for long term care facilities housing people with brain injury to make changes that may result in greater well-being of their residents.
MT 2018
38
Persaud, Malini. "Pleasure in the Daily Lives of People Living with Advanced Dementia in a Long-term Care Facility: A Multiple Case Study Approach." Thesis, 2009. http://hdl.handle.net/1807/17816.
Анотація:
According to the Canadian Study of Health and Aging most of the 12,630 Canadians living with advanced dementia reside in long-term care facilities. This number is rising due to an aging population. The purpose of this study is to address an identified gap in our knowledge about what creates pleasure in people with advanced dementia, through first understanding family caregivers’ ways of eliciting and interpreting positive emotions in their relatives and then having the personal support worker (PSW) try these same approaches to see if similar responses are achieved. This study used a qualitative multiple case study design. Data collection methods included digitally recorded interviews and video-recorded observations of interactions between residents and caregivers. A case is defined as a resident with moderately to severely advanced dementia. Each case had two informants: a family member and a PSW meeting inclusion criterion. There were seven cases. The resident participants spanned a range from moderately advanced to severely advanced dementia. Data analysis used both inductive and deductive coding with sensitizing concepts of selfhood, personhood, continuity of personality and well-being.
The results of this study centred on four main themes related to the research questions about the sources and indicators of pleasure and the potential for PSWs to replicate what family members did with residents. Some sources of pleasure were lost, some were maintained and new ones developed post-illness in all of the residents. Both family members and PSWs were knowledgeable about sources and indicators of pleasure for the people with dementia they were involved with. The analysis demonstrated that for individuals with very advanced dementia, the concept of pleasure or enjoyment is not applicable. The family members of the two residents with very advanced dementia used music, touch and sweets to elicit a pleasurable response but the resident did not display indicators of pleasure in response; instead, the residents responded with grasping or other responses which require further research to understand fully. Future research should build upon these findings in order to further understand the concept of positive affect: pleasure, interest and enjoyment in people with advanced dementia of the Alzheimer type.
39
Moremi, Lillian Serah. "Pain management in people living with HIV in home based care." Thesis, 2014. http://hdl.handle.net/10500/14180.
Анотація:
The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework.
This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study.
Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively.
The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV.Health Studies
D. Litt. et Phil. (Health Studies)
40
Chatters, R., J. Roberts, Gail Mountain, S. Cook, G. Windle, C. Craig, and K. Sprange. "The long-term (24-month) effect on health and well-being of the Lifestyle Matters community-based intervention in people aged 65 years and over: a qualitative study." 2017. http://hdl.handle.net/10454/15704.
Анотація:
YesObjectives To assess the long-term effect on health and well-being of the Lifestyle Matters programme. Design Qualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT). Setting The intervention took place at community venues within two sites in the UK. Participants A purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being. Intervention Lifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy. Results Interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed. Conclusion The majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained.
Medical Research Council grant number (G1001406).
41
Chen, Chen-Hua, and 陳甄華. "Study the Effect of Our Nation's Long-Term Nursing and Caring System on the Elderly People Living Alone in the Communities-Take Yongsheng and Singye Communities in XinyingDist.,TainanCity,as Example." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/85mjv3.
Анотація:
碩士環球科技大學
公共事務管理研究所
105
Recently, due to the effect of decreasing new-born babies in our country, the substantial enhancement of the quality of our medical treatment as well as our awareness of the health care and healthy diets, the average life span of our people has been prolonged. As a result, our aging population has also increased rapidly. This thesis, via the study of the structurally-similiar "Yung-Sheng Community" and "Hsing-Ye Community" in Tainan city will investigate whether our long-term caring and nursing policy has substantial effects on the elderly people living alone. Whether there are adequate methods to improve the various problems caused by the deficiency of our long-term caring and nursing system will also be discussed. Our fertility rate has deteriorated dramatically and the aging speed of our population has already gone beyond Japan becoming the world number one. So the long-term caring and nursing for the elderly has become the imperative thing to do. Though the solution rate related to the everyday life is comparatively higher among the “long-term caring and nursing" related problems, the health care related problems are usually noticed easily and thus put greater emphasis on. Therefore, "health care" is till the top priority in the long-term caring and nursing system. However, there are differences between the health care related problems and the service as well as information provided by our current medical systems. So, setting up a new system to deal with them is required.
42
MacLeod, Suzanne. "From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times." Thesis, 2014. http://hdl.handle.net/1828/5213.
Анотація:
As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.Graduate
0452
0680
0351
macsuz@shaw.ca