The use of universal or standard precautions by health care workers (HCWs) is essential to avoid exposure to blood and other body secretions that may transmit infectious diseases. Health care workers in Uganda often find it difficult to translate the principles of universal precautions into practice. Without appropriate use of universal precautions, disease transmission to HCWs may rise. In a resource-constrained environment such as Uganda however, nurses typically do not practice universal precautions unless they know the patients HIV or AIDS status. There is a need to understand the experiences and the context in which nurses practice universal precautions. Therefore, the purpose of this study was to explore the experience of Ugandan nurses and midwives in the practice of universal precautions and to identify factors that influence the use of universal precautions by nurses while caring for persons living with HIV and AIDS. A qualitative research approach, using a focused ethnography was used for the study.

A diagnosis of cancer represents a significant crisis for the child and their family. As the treatment for childhood cancer has improved dramatically over the past three decades, most children diagnosed with cancer today survive this illness. However, it is still an illness which severely disrupts the lifestyle and typical functioning of the family unit. Most treatments for cancer involve lengthy hospital stays, the endurance of painful procedures and harsh side effects. Research has confirmed that to manage and adapt to such a crisis, families must undertake measures which assist their adjustment. Variables such as level of family support, quality of parents’ marital relationship, coping of other family members, lack of other concurrent stresses and open communication within the family have been identified as influences on how well families adjust to a diagnosis of childhood cancer. Theoretical frameworks such as the Resiliency Model of Family Adjustment and Adaptation (McCubbin and McCubbin, 1993, 1996) and the Stress and Coping Model by Lazarus and Folkman (1984) have been used to explain how families and individuals adapt to crises or adverse circumstances. Developmental theories have also been posed to account for how children come to understand and learn about the concept of illness. However more descriptive information about how families and children in particular, experience and manage a diagnosis of cancer is still needed. There are still many unanswered questions surrounding how a child adapts to, understands and makes meaning from having a life-threatening illness. As a result, developing an understanding of the impact that such a serious illness has on the child and their family is crucial. A new approach to examining childhood illness such as cancer is currently underway which allows for a greater understanding of the experience of childhood cancer to be achieved. This new approach invites a phenomenological method to investigate the perspectives of those affected by childhood cancer. In the current study 9 families in which there was a diagnosis of childhood cancer were interviewed twice over a 12 month period. Using the qualitative methodology of Interpretative Phenomenological Analysis (IPA) a semi-structured interview was used to explicate the experience of childhood cancer from both the parent and child’s perspectives. A number of quantitative measures were also administered to gather specific information on the demographics of the sample population. The results of this study revealed a number of pertinent areas which need to be considered when treating such families. More importantly experiences were explicated which revealed vital phenomena that needs to be added to extend current theoretical frameworks. Parents identified the time of the diagnosis as the hardest part of their entire experience. Parents experienced an internal struggle when they were forced to come to the realization that they were not able to help their child get well. Families demonstrated an enormous ability to develop a new lifestyle which accommodated the needs of the sick child, as the sick child became the focus of their lives. Regarding the children, many of them accepted their diagnosis without complaint or question, and they were able to recognise and appreciate the support they received. Physical pain was definitely a component of the children’s experience however the emotional strain of loss of peer contact seemed just as severe. Changes over time were also noted as both parental and child experiences were often pertinent to the stage of treatment the child had reached. The approach used in this study allowed for rich and intimate detail about a sensitive issue to be revealed. Such an approach also allowed for the experience of childhood cancer on parents and the children to be more fully realised. Only now can a comprehensive and sensitive medical and psychosocial approach to the child and family be developed. For example, families may benefit from extra support at the time of diagnosis as this was identified as one of the most difficult periods. Parents may also require counselling support in coming to terms with their lack of ability to help their child heal. Given the ease at which children accepted their diagnosis, we need to question whether children are more receptive to adversity. Yet the emotional struggle children battled as a result of their illness also needs to be addressed.

Background: Therapeutic relationships in psychiatry services have been shown to have a significant impact on outcomes for people in severe mental distress. Service user experience-based studies consistently show relationships are an important factor in either helping or hindering recovery. Few studies have conducted a detailed exploration into the interpersonal mechanisms within these relationships by asking service users directly about what emotional impact these relationships have had on them. This is important knowledge for improving the quality of mental healthcare for people in severe mental distress. Aims: The purpose was to co-create a piece of research with a service user organisation that explored services users' experiences and perceptions of helpful and hindering relationships with mental health practitioners. The aim was to gain a greater understanding of the components in the relationship that brought about psychological change. Little research about relationships in psychiatry settings has been conducted in collaboration with service users outside of government-led mental health services. Participants: Eight participants were recruited from the service user organisation. The participants self-reported as having a mental health problem. Seven of the eight participants had long-term experience of using psychiatry services. Method: This research was service user-informed. The data was collected using single in-depth interviews focused on service users' views of their relationships with mental health practitioners. Interpretative Phenomenological Analysis (IPA) methodology was used to analyse the data and explore the participants' lived experiences of relationships in mental health services. Findings: The main themes identified were 'Trying to survive: am I a person or just an object in the system', 'Traumatic experiences and relationships' and 'Transformative relationships'. The findings showed the transformative components of these relationships were power, security and identity. The findings highlighted how the participants experienced a relationship to the system of psychiatry through their relationships with staff. Conclusions: How the components of power, security and identity were managed by practitioners determined whether relationships helped or hindered recovery. The responsibility for relationships in psychiatry needs to be broadened beyond the interpersonal relationship provided by practitioners. The systemic institution of psychiatry based on statutory control, risk aversion, the biomedical model and under resourcing were a cause of many of the problems in relationships in psychiatry settings.

AbstractThe University of ManchesterMichael Lewis Humphreys Doctorate in Educational and Child PsychologyAn Exploration into Children’s Experiences of Pupil Mobility2012Pupil mobility, defined as “a child joining or leaving a school at a point other than at the normal age at which children start or finish their education at that school” (Dobson & Henthorne, 1999 p. vi), is a complex phenomenon that is linked to the academic, social and emotional outcomes of children and young people (Gagnon & Malmgren, 2005; Mehana & Reynolds, 2004; South & Haynie, 2004). There is limited published research that has illuminated pupil mobility through eliciting the views of the pupils, their families and class teachers. This qualitative study explored how children experienced pupil mobility when it was combined with a residential move and the factors that were perceived to affect the experience. A multiple case study design with embedded (multiple) units of analysis was adopted (Yin, 2009). Each case study consisted of a Key Stage 2 aged child who had moved into a northern coastal Local Authority within six months of the data collection. The data was gathered through semi-structured interviews in two primary schools. Four children, five parents and five class teachers took part in the study.The interviews were audio recorded and transcribed before being analysed through thematic analysis (Braun & Clarke, 2006). The analysis identified key themes raised in the interviews in relation to how the children experienced pupil mobility and the factors that were perceived to have impacted upon this experience. The findings of this study highlight that pupil mobility is a challenging experience for children that elicits a contrasting range of emotions which are affected by a series of interactions between the children and the systems around them. The findings are discussed in relation to psychological theories and previous research. Implications are considered for the practice of Local Authority personnel, school staff, parents and educational psychologists and suggestions for future research are highlighted.

A dissertation submitted to the Faculty of Education in the fulfilment of the requirements for the degree of Master of Education in the Department of Educational Psychology and Special Education at the University of Zululand, South Africa, 2012. / This study examined the experiences of young school-going mothers with regard to how their teachers, classmates/peers and the community view them. A qualitative research design was deemed on appropriate approach for this study. The sample comprised of 10 young school- going mothers from 5 high schools in Leribe district of Lesotho. Interviews were used to collect data individually and in focus groups. Data were analyzed qualitatively using the process of content analysis. Information emanating from the interviewers were transcribed and coded into themes pertaining to the school-going mothers’ experiences in high schools. The findings suggest that the young mothers were not supported by some of their teachers; they were rejected by their peers and classmates and, labeled by the community they live in. Sample comprised 10 young mothers from 5 high schools in Leribe district of Lesotho. On the basis of the findings, both curative and preventative strategies were recommended for dealing with young school going mothers.

The night shift environment in an inpatient hospice facility is unique in care and relegates challenging situations for the nursing staff. Using the Parse methodology, the purpose of this project was to explore the challenges faced by inpatient hospice facility night shift nursing staff in providing a continuum of care for dying patients and their families. Nine night shift hospice nurses participated in 45-60 minute interviews. The interviews were conducted in a hospice quiet room or a designated place of comfort for the participant, which allowed for dialogical engagement. The interviews were unstructured with open-ended questions about lived experiences. The interpretive phenomenological approach was used to understand positive outcomes and management involvement and developing positive morale. Descriptive coding was used to collect and analyze data. According to study findings, hospice night shift nursing staff were exposed to the stressors of dying patients, their families, a dissatisfied work environment, and their personal life. The core concepts addressed by the participants were feeling isolated and disrespected, staff development, and using coping strategies. Strong relationships through coping mechanisms were developed on the night shift, but the unmet issues of the staff were poorly regarded. The study perpetuates the need for further research in understanding the experiences of hospice night shift nursing staff and the changes needed to eliminate imminent night shift turnover.

Positive Childhood Experiences are protective social determinants of health factors that mitigate downstream consequences of exposure to chronic adversity and abuse specific to Adverse Childhood Experiences (ACEs). ACEs are defined by the CDC as potentially traumatic experiences during childhood that increase mal-adaptive and risky behaviors, negative health outcomes, and relative health care utilization throughout the lifecycle. This study examines the association between PCE scores and important socio-economic measures. A cross-sectional study using the 2021 Tennessee Behavioral Risk Factor Surveillance Survey PCE module was conducted. The PCE’s module included 7 questions to assess PCE’s during childhood. The 7 PCE questions were consolidated into a measure categorized by low: 0-1 PCE, middle: 2-4 PCEs, and high: 5-7 PCEs. The association between PCE’s and three independent variables of interest were examined: income, employment status, and education. Income was defined by household income and categorized into high ($100,000+) middle ($50,000-$99,000), and low income ($0-$49,000). Education was categorized into high (graduated college or technical school), middle (graduated high school/attended college or technical school), and low education levels (did not graduate high school). Employment status was dichotomized into employed vs unemployed. Chi-square test of independence was used to investigate associations between PCE’s scores and the 3 socio-economic variables, income, employment status, and education, independently. There was a significant association between PCE score and income (P=.001). Over a quarter of individuals with a high PCE score (27%) were in the lowest income category, while 53% were in the highest income category. Of the individuals with a low PCE score 49% were in the lowest income category while 31% were in the highest income category. For individuals with a middle PCE score, 39% were in the lowest income category, while 42% were in the highest income category. The association between PCE score and education level was also significant (P=.001). Of individuals with a low PCE score 61% were employed, those with a middle PCE score 74% were employed, and of samples with a high PCE score 88% were employed. Analysis of PCE score and employment status was also significant (P=.001). Of the individuals with a low PCE score 21% were in the highest education category, of individuals with a middle PCE score 31% were in the highest education category, and of individuals with a high PCE score 41% were in the highest education category. Evidence continues to mount that PCE’s are associated with improved mental health, better social skills, and overall self-reported quality of life on an individual and population level. The findings of this study suggest that positive childhood experiences impact individuals’ ability to overcome adversity if income, education, and employment levels are accepted as proxy measure for quality of life and highlight the importance of fostering positive environments for children to prevent long term negative health, social, and economic impacts. Future research could further explore the mechanisms through which positive childhood experiences lead to positive outcomes, and the implications for interventions aimed at promoting positive childhood experiences across socio-demographic categories.

No description available.

Aim: The aim of this study was to explore care leavers’ experiences of parenting. Although research has previously been carried out on this area, there is a lack of research on mature care leavers’ experiences of parenthood which this study attempts to address. It was hoped that this research might further illuminate our understanding of care leavers as parents, and highlight potential areas of clinical need and ways in which these could be addressed therapeutically. Method: This study employed a qualitative design through the use of semi-structured interviews with six care leavers who were mothers; the majority of whom were in their late 30’s to early 40’s. Interpretative Phenomenological Analysis (IPA) was used to develop a rich and multi-layered account of participants’ experiences. Results: Four main themes emerged across participants’ accounts. These were: ‘Fear of the past and its impact on the future’, ‘Trying to do better’, ‘Parenting is hard but rewarding’ and ‘Connecting and disconnecting: the push and pull.’ Implications: The study highlights the importance of holding the complexity of care leavers’ experiences as parents in mind; acknowledging both their strengths and struggles. Participants’ sense-making of their parenting in relation to their pasts as well as their resources and the processes surrounding learning to parent, were discussed in light of the themes that arose and previous theoretical and research literature. Clinical implications and recommendations for future research are also discussed.

Bakgrund: Den äldre befolkningen i världen ökar och med den ökar även den psykiska ohälsan, där depression är en av de vanligaste neurologiska funktionsnedsättningarna hos äldre personer. Det har visat sig att kunskap om depression hos äldre personer är bristfällig inom sjukvården och att många äldre personer aldrig blir diagnostiserade och aldrig får adekvat hjälp. Syfte: Syftet med litteraturstudien var att belysa äldre personers upplevelser av depression. Metod: Åtta artiklar med kvalitativ ansats sammanställdes och analyserades med kvalitativ innehållsanalys för att sedan utgöra litteraturstudiens resultat. Artikelsökningarna genomfördes i databaserna Cinahl, PubMed och PsycINFO. Resultat: Resultatet visade att äldre personer med depression upplevde förändring i upplevelsen av sig själv, både kroppslig förändring och en förändrad självbild. Negativa känslor framträdde såsom upplevelser av ensamhet, rädsla och självförakt. Sociala aspekter som framkom innefattade bland annat en rädsla av att bli beroende av andra och känslor inför omvärldens syn på depression. Existentiella aspekter framträdde som tankar och minnen, hopplöshet och funderingar kring meningen med livet. Konklusion: Olika faktorer har betydelse för äldre personers upplevelser av depression och det behövs mer kunskap hos vårdpersonal inom området. Ökad kunskap kring depression hos äldre personer behövs för att inom sjukvården kunna förebygga, identifiera symtom och behandla sjukdomen. / Background: The elderly population is increasing worldwide and with it comes an increase in mental illness, where depression is one of the most common neurological functional limitation in older persons. It has been shown that knowledge about depression in older persons is deficient in health care and that many older persons are never diagnosed and never receives adequate help. Aim: The purpose of the study was to explore older person’s experiences of depression. Method: Eight articles with qualitative approach were compiled and analyzed using qualitative content analysis to provide the result of the literature study. Article search was performed in the databases Cinahl, PubMed and PsycINFO. Result: The result showed that older persons with depression experienced a change in the perception of self, both a physical change and a change in self-image. Negative emotions appeared such as experiences of loneliness, fear and self-contempt. Social aspects that emerged included among others a fear of becoming dependent on others and the surrounding world’s view of depression. Existential aspects appeared as thoughts and memories, hopelessness and thoughts about the meaning of life. Conclusion: Many different factors are important to older person’s experiences of depression and more knowledge in the field is needed among health care professionals. Increased knowledge about depression in elderly persons is needed in health care to be able to prevent, identify symptoms and treat the disease.